Calcium
Antagonists Help Control Blood Pressure
downloadable
pdf
A
massive study aimed at settling the long-standing debate
over the usefulness of calcium antagonists for treating
high blood pressure has shown the drugs are part of
a safe and effective regimen for patients who don’t
respond to standard medicines — or who stop taking
them because of bothersome side effects, University
of Florida researchers report.
The
news likely will help physicians better customize therapy
for hypertensive patients who also have coronary artery
disease, particularly those at high risk of heart attack,
stroke or death. Preliminary findings also indicated
a calcium antagonist strategy, compared with traditional
therapy using beta-blockers and diuretics, prevents
diabetes in these patients.
“Now
there’s an alternative to what’s considered
the standard of care,” said Dr. Carl J. Pepine,
the study’s principal investigator and chief of
cardiovascular medicine at UF’s College of Medicine.
“The big problem with hypertension is treatment
and compliance with treatment. Surveys show that perhaps
only 30 percent or less of the patients in the United
States who are known to be hypertensive are on treatment
and even a smaller percentage are at blood pressure
goal for their treatment. It is believed that an important
reason for that is the inability to tolerate the treatments.
So here we have an alternative treatment strategy that
appears to be just as good in terms of preventing adverse
outcomes and maybe even better in terms of preventing
the emergence of new diabetes cases.”
Pepine,
the newly installed president of the American College
of Cardiology, or ACC, announced the results of the
landmark International Verapamil SR-Trandolapril study,
funded by Abbott Laboratories and known as INVEST, at
the ACC’s 52nd annual Scientific Session in Chicago
last spring.
More
than 50 million Americans have high blood pressure,
according to the American Heart Association. Elevated
blood pressure is associated with up to half of all
cases of coronary artery disease, the No. 1 killer of
men and women in the United States.
“We’re
seeing huge numbers of patients with coronary artery
disease and hypertension as our population ages,”
Pepine said. “The question we ask now is how is
their blood pressure best managed? The literature up
until the completion of our study was relatively void
of evidence-based data in terms of what’s best
for controlling blood pressure in this population.”
Physicians
have used calcium antagonists to treat heart-related
ailments for more than two decades. Studies have shown
calcium antagonists and beta-blockers are of similar
benefit for patients with the chest pain known as stable
angina pectoris. But beta-blockers have been better
for those who have suffered a heart attack.
In
the INVEST study, UF researchers tracked more than 22,500
patients for two to five years to determine whether
a high blood pressure treatment strategy that included
the calcium antagonist verapamil was at least as effective
as beta-blockers and diuretics at lowering blood pressure
below 130/85. Patients at 862 sites around the world
were randomly assigned to one of the two treatment strategies.
Scientists
also were intrigued to learn new cases of diabetes occurred
less frequently among those assigned to the calcium
antagonist regimen. Many heart disease patients with
high blood pressure are at greatly increased risk of
developing diabetes, which is rapidly nearing epidemic
rates in the United States. Preventing diabetes would
have tremendous public health implications, Pepine said,
and could greatly reduce related health-care costs.
Carl J. Pepine, pepincj@medicine.ufl.edu
by
Melanie Fridl Ross
|