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David J. Addley, Deborah Williams, Kyoung S. Kim, Charles L. Curry, P-243: Calcium channel blockers decrease mortality in elderly African-American survivors of acute myocardial infarctions, American Journal of Hypertension, Volume 14, Issue S1, April 2001, Page 110A, https://doi.org/10.1016/S0895-7061(01)01433-9
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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 women . | receiving CCB . | not receiving CCB . | difference in risk . | relative risk . | 95% confidence interval . |
<140 | 23.6 | 22 | 1.6 | 1.074 | 1.073-1.074 |
140-159 | 27 | 23.7 | 3.3 | 1.38 | 1.136-1.141 |
160-169 | 29.4 | 26.2 | 3.2 | 1.119 | 1.110-1.129 |
170-179 | 33.9 | 27.6 | 6.3 | 1.229 | 1.211-1.248 |
≥180 | 39.8 | 25.9 | 13.9 | 1.535 | 1.513-1.558 |
elderly white men | |||||
<140 | 20.7 | 19.2 | 1.5 | 1.081 | 1.080-1.082 |
140-159 | 23.4 | 19.8 | 3.6 | 1.181 | 1.178-1.184 |
160-169 | 27 | 20.3 | 6.7 | 1.329 | 1.315-1.343 |
170-179 | 30.9 | 25.7 | 5.2 | 1.199 | 1.71-1.227 |
≥180 | 35.3 | 27.5 | 7.8 | 1.283 | 1.244-1.322 |
elderly black women | |||||
<140 | 24.7 | 30.1 | -5.4 | 0.821 | 0.812-0.830 |
140-159 | 29 | 30.7 | -1.7 | 0.945 | 0.925-0.965 |
160-169 | 34.6 | 36.6 | -2 | 0.948 | 0.893-1.002 |
170-179 | 36.2 | 42.4 | -6.2 | 0.854 | 0.760-0.947 |
elderly black men | |||||
<140 | 26.4 | 27.4 | -1 | 0.962 | 0.95-0.974 |
140-159 | 25.6 | 28.1 | -2.5 | 0.913 | 0.879-0.947 |
160-169 | 31 | 38.1 | -7.1 | 0.813 | 0.696-0.930 |
SBP . | . | . | . | . | . |
---|---|---|---|---|---|
elderly white women . | receiving CCB . | not receiving CCB . | difference in risk . | relative risk . | 95% confidence interval . |
<140 | 23.6 | 22 | 1.6 | 1.074 | 1.073-1.074 |
140-159 | 27 | 23.7 | 3.3 | 1.38 | 1.136-1.141 |
160-169 | 29.4 | 26.2 | 3.2 | 1.119 | 1.110-1.129 |
170-179 | 33.9 | 27.6 | 6.3 | 1.229 | 1.211-1.248 |
≥180 | 39.8 | 25.9 | 13.9 | 1.535 | 1.513-1.558 |
elderly white men | |||||
<140 | 20.7 | 19.2 | 1.5 | 1.081 | 1.080-1.082 |
140-159 | 23.4 | 19.8 | 3.6 | 1.181 | 1.178-1.184 |
160-169 | 27 | 20.3 | 6.7 | 1.329 | 1.315-1.343 |
170-179 | 30.9 | 25.7 | 5.2 | 1.199 | 1.71-1.227 |
≥180 | 35.3 | 27.5 | 7.8 | 1.283 | 1.244-1.322 |
elderly black women | |||||
<140 | 24.7 | 30.1 | -5.4 | 0.821 | 0.812-0.830 |
140-159 | 29 | 30.7 | -1.7 | 0.945 | 0.925-0.965 |
160-169 | 34.6 | 36.6 | -2 | 0.948 | 0.893-1.002 |
170-179 | 36.2 | 42.4 | -6.2 | 0.854 | 0.760-0.947 |
elderly black men | |||||
<140 | 26.4 | 27.4 | -1 | 0.962 | 0.95-0.974 |
140-159 | 25.6 | 28.1 | -2.5 | 0.913 | 0.879-0.947 |
160-169 | 31 | 38.1 | -7.1 | 0.813 | 0.696-0.930 |
SBP . | . | . | . | . | . |
---|---|---|---|---|---|
elderly white women . | receiving CCB . | not receiving CCB . | difference in risk . | relative risk . | 95% confidence interval . |
<140 | 23.6 | 22 | 1.6 | 1.074 | 1.073-1.074 |
140-159 | 27 | 23.7 | 3.3 | 1.38 | 1.136-1.141 |
160-169 | 29.4 | 26.2 | 3.2 | 1.119 | 1.110-1.129 |
170-179 | 33.9 | 27.6 | 6.3 | 1.229 | 1.211-1.248 |
≥180 | 39.8 | 25.9 | 13.9 | 1.535 | 1.513-1.558 |
elderly white men | |||||
<140 | 20.7 | 19.2 | 1.5 | 1.081 | 1.080-1.082 |
140-159 | 23.4 | 19.8 | 3.6 | 1.181 | 1.178-1.184 |
160-169 | 27 | 20.3 | 6.7 | 1.329 | 1.315-1.343 |
170-179 | 30.9 | 25.7 | 5.2 | 1.199 | 1.71-1.227 |
≥180 | 35.3 | 27.5 | 7.8 | 1.283 | 1.244-1.322 |
elderly black women | |||||
<140 | 24.7 | 30.1 | -5.4 | 0.821 | 0.812-0.830 |
140-159 | 29 | 30.7 | -1.7 | 0.945 | 0.925-0.965 |
160-169 | 34.6 | 36.6 | -2 | 0.948 | 0.893-1.002 |
170-179 | 36.2 | 42.4 | -6.2 | 0.854 | 0.760-0.947 |
elderly black men | |||||
<140 | 26.4 | 27.4 | -1 | 0.962 | 0.95-0.974 |
140-159 | 25.6 | 28.1 | -2.5 | 0.913 | 0.879-0.947 |
160-169 | 31 | 38.1 | -7.1 | 0.813 | 0.696-0.930 |
SBP . | . | . | . | . | . |
---|---|---|---|---|---|
elderly white women . | receiving CCB . | not receiving CCB . | difference in risk . | relative risk . | 95% confidence interval . |
<140 | 23.6 | 22 | 1.6 | 1.074 | 1.073-1.074 |
140-159 | 27 | 23.7 | 3.3 | 1.38 | 1.136-1.141 |
160-169 | 29.4 | 26.2 | 3.2 | 1.119 | 1.110-1.129 |
170-179 | 33.9 | 27.6 | 6.3 | 1.229 | 1.211-1.248 |
≥180 | 39.8 | 25.9 | 13.9 | 1.535 | 1.513-1.558 |
elderly white men | |||||
<140 | 20.7 | 19.2 | 1.5 | 1.081 | 1.080-1.082 |
140-159 | 23.4 | 19.8 | 3.6 | 1.181 | 1.178-1.184 |
160-169 | 27 | 20.3 | 6.7 | 1.329 | 1.315-1.343 |
170-179 | 30.9 | 25.7 | 5.2 | 1.199 | 1.71-1.227 |
≥180 | 35.3 | 27.5 | 7.8 | 1.283 | 1.244-1.322 |
elderly black women | |||||
<140 | 24.7 | 30.1 | -5.4 | 0.821 | 0.812-0.830 |
140-159 | 29 | 30.7 | -1.7 | 0.945 | 0.925-0.965 |
160-169 | 34.6 | 36.6 | -2 | 0.948 | 0.893-1.002 |
170-179 | 36.2 | 42.4 | -6.2 | 0.854 | 0.760-0.947 |
elderly black men | |||||
<140 | 26.4 | 27.4 | -1 | 0.962 | 0.95-0.974 |
140-159 | 25.6 | 28.1 | -2.5 | 0.913 | 0.879-0.947 |
160-169 | 31 | 38.1 | -7.1 | 0.813 | 0.696-0.930 |
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.