Abstract

Calcium channel blockers (CCBs) are effective in treating hypertension and angina. This class of drug has been under great scrutiny as to their safety profile because of reports of increased coronary artery disease mortality. Yet, recent studies suggest that CCBs decrease the relative risk of cardiovascular events. We reveiwed data from the Cooperative Cardiovascular Project to determine the impact of various levels of systolic blood pressure(SBP) on survival when patients were treated or not treated with CCBs. (See Table)

SBP
elderly white womenreceiving CCBnot receiving CCBdifference in riskrelative risk95% confidence interval
<14023.6221.61.0741.073-1.074
140-1592723.73.31.381.136-1.141
160-16929.426.23.21.1191.110-1.129
170-17933.927.66.31.2291.211-1.248
≥18039.825.913.91.5351.513-1.558
elderly white men
<14020.719.21.51.0811.080-1.082
140-15923.419.83.61.1811.178-1.184
160-1692720.36.71.3291.315-1.343
170-17930.925.75.21.1991.71-1.227
≥18035.327.57.81.2831.244-1.322
elderly black women
<14024.730.1-5.40.8210.812-0.830
140-1592930.7-1.70.9450.925-0.965
160-16934.636.6-20.9480.893-1.002
170-17936.242.4-6.20.8540.760-0.947
elderly black men
<14026.427.4-10.9620.95-0.974
140-15925.628.1-2.50.9130.879-0.947
160-1693138.1-7.10.8130.696-0.930
SBP
elderly white womenreceiving CCBnot receiving CCBdifference in riskrelative risk95% confidence interval
<14023.6221.61.0741.073-1.074
140-1592723.73.31.381.136-1.141
160-16929.426.23.21.1191.110-1.129
170-17933.927.66.31.2291.211-1.248
≥18039.825.913.91.5351.513-1.558
elderly white men
<14020.719.21.51.0811.080-1.082
140-15923.419.83.61.1811.178-1.184
160-1692720.36.71.3291.315-1.343
170-17930.925.75.21.1991.71-1.227
≥18035.327.57.81.2831.244-1.322
elderly black women
<14024.730.1-5.40.8210.812-0.830
140-1592930.7-1.70.9450.925-0.965
160-16934.636.6-20.9480.893-1.002
170-17936.242.4-6.20.8540.760-0.947
elderly black men
<14026.427.4-10.9620.95-0.974
140-15925.628.1-2.50.9130.879-0.947
160-1693138.1-7.10.8130.696-0.930
SBP
elderly white womenreceiving CCBnot receiving CCBdifference in riskrelative risk95% confidence interval
<14023.6221.61.0741.073-1.074
140-1592723.73.31.381.136-1.141
160-16929.426.23.21.1191.110-1.129
170-17933.927.66.31.2291.211-1.248
≥18039.825.913.91.5351.513-1.558
elderly white men
<14020.719.21.51.0811.080-1.082
140-15923.419.83.61.1811.178-1.184
160-1692720.36.71.3291.315-1.343
170-17930.925.75.21.1991.71-1.227
≥18035.327.57.81.2831.244-1.322
elderly black women
<14024.730.1-5.40.8210.812-0.830
140-1592930.7-1.70.9450.925-0.965
160-16934.636.6-20.9480.893-1.002
170-17936.242.4-6.20.8540.760-0.947
elderly black men
<14026.427.4-10.9620.95-0.974
140-15925.628.1-2.50.9130.879-0.947
160-1693138.1-7.10.8130.696-0.930
SBP
elderly white womenreceiving CCBnot receiving CCBdifference in riskrelative risk95% confidence interval
<14023.6221.61.0741.073-1.074
140-1592723.73.31.381.136-1.141
160-16929.426.23.21.1191.110-1.129
170-17933.927.66.31.2291.211-1.248
≥18039.825.913.91.5351.513-1.558
elderly white men
<14020.719.21.51.0811.080-1.082
140-15923.419.83.61.1811.178-1.184
160-1692720.36.71.3291.315-1.343
170-17930.925.75.21.1991.71-1.227
≥18035.327.57.81.2831.244-1.322
elderly black women
<14024.730.1-5.40.8210.812-0.830
140-1592930.7-1.70.9450.925-0.965
160-16934.636.6-20.9480.893-1.002
170-17936.242.4-6.20.8540.760-0.947
elderly black men
<14026.427.4-10.9620.95-0.974
140-15925.628.1-2.50.9130.879-0.947
160-1693138.1-7.10.8130.696-0.930

Omitted data is due to insufficient number of patients. We did not analyze the data for specific types of CCBs. The data showed that at matching SBP quintiles elderly African-Americans had a lower relative risk of death than their white counterparts while receiving CCBs. This data suggests that CCBs were effective in decreasing two year mortality in elderly African-Americans, particularly those with the highest level of SBP.

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