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Calcium Channel Blockers

Click here for why I feel that Micardis® (telmisartan) should be the first line treatment for hypertension.

Related Topics:

• Hypertension / pulse pressure / hardening of the arteries / angiotensin II receptor blockers (ARBs) / ace inhibitors / alpha blockers / calcium channel blockers / diuretics / beta blockers / Renin Inhibitors /  Vanlev (omapatrilat) / aldosterone blockers / dihydropyridine (DHP) calcium antagonist / first line treatment for hypertension

News & Research:

• Blood pressure drug linked with increased risk of bowel condition - Science Daily, 7/3/19 - "This condition causes small bulges or pouches to appear in the lining of the intestine. Particularly affecting the elderly (as many as 65 per cent of over 85s may be affected), diverticulosis can in some cases can lead to a medical emergency if the pouches become infected or burst ... the versions of genes related to the effects of a particular type of calcium channel blocker -- the non-dihydropyridine class, were linked to an increased the risk of a bowel condition called diverticulosis ... This is the first time that this class of blood pressure drug has been associated with diverticulosis. We're not sure of the underlying mechanism -- although it may relate to effects on the function of intestine muscles, which perform contractions to transport food through the gut"
• Calcium Channel Blocker Use and the Risk for Prostate Cancer: A Population-Based Nested Case-Control Study - Pharmacotherapy. 2019 Mar 27 - "The results of this large population-based study indicate a modest but significant increase in the risk of PCa among CCB users, and the risk increases with duration of use"
• BP Meds Tied to Pancreatic Cancer Risk in Women - Medscape, 4/18/18 - "those who had ever taken a short-acting calcium channel blocker (CCB) saw their pancreatic cancer risk shoot up by 66 percent ... short-acting CCBs are "the least effective" blood pressure drug available"
• Risk of Breast Cancer With Long-term Use of Calcium Channel Blockers or Angiotensin-Converting Enzyme Inhibitors Among Older Women - Medscape, 4/26/17 - "Increasing duration of ACEi use was associated with reduced breast cancer risk: Compared with 1–<2 years of use, the adjusted hazard ratio was 0.76 (95% confidence interval: 0.63, 0.92) for 5–<6 years of use and 0.63 (95% confidence interval: 0.43, 0.93) for 9–<10 years of use. We conclude that among older women with hypertension, long-term CCB use does not increase breast cancer risk and long-term treatment with ACEis may confer protection against breast cancer"
• Antihypertensive drugs decrease risk of Alzheimer disease: Ginkgo Evaluation of Memory Study - Neurology. 2013 Aug 2 - "Secondary longitudinal data analysis of the Ginkgo Evaluation of Memory Study in older adults at least 75 years of age with normal cognition (n = 1,928) or MCI (n = 320) over a median 6.1-year period ... Hazard ratio for incident AD dementia among participants with normal cognition was 0.51 in diuretic (95% confidence interval [CI] 0.31-0.82), 0.31 in ARB (95% CI 0.14-0.68), 0.50 in ACE-I (95% CI 0.29-0.83), 0.62 in CCB (95% CI 0.35-1.09), and 0.58 in BB (95% CI 0.36-0.93) users and was not significantly altered when mean systolic blood pressure was above 140 mm Hg" - Note:  Sounds like the ARB's left the others in the dust.  See my telmisartan as a first line treatment page.
• Some Antihypertensives Linked to Breast Cancer Risk - Medscape, 8/5/13 - "Women who had taken calcium-channel blockers for 10 years or more had more than double the usual risk for invasive ductal breast carcinoma (IDC) (odds ratio [OR], 2.4) and for invasive lobular breast carcinoma (ILC) (OR, 2.6). The researchers also observed a possible association between the long-term use of ACE inhibitors and reduced risks for both IDC (OR, 0.7) and ILC (OR, 0.6), although the risk estimate for IDC was within the limits of chance ... The mechanism behind the apparent calcium-channel blocker effect is not known ... but some researchers suspect that these drugs might increase cancer risk by inhibiting apoptosis ... If the 2- to 3-fold increase in risk found in this study is confirmed, long-term calcium-channel blocker use would take its place as one of the major modifiable risk factors for breast cancer. Thus it is important that efforts be made to replicate the findings"
• Use of antihypertensive medications and breast cancer risk - Cancer Causes Control. 2012 Dec 8 - "antihypertensive medications (AHTs) ... We re-evaluated the relationship between AHT use and breast cancer risk in a prospective cohort of 3,201 women ≥65 years of age at recruitment now with more than double the length of follow-up (12 vs. 5 years) and substantially more breast cancer diagnoses (188 compared with 75 cases) ... Compared with women who reported no use of AHTs, women who had used calcium channel blockers (CCB) within the past two years had a 1.6-fold increased risk of breast cancer (95 % confidence interval (CI): 1.0-2.5), and in particular, recent users of immediate-release CCBs had a 2.4-fold increased risk (95 % CI: 1.3-4.5). Neither ever nor recent use of any other type of AHT was associated with breast cancer risk"
• Telmisartan, an Angiotensin II Type 1 Receptor Blocker, Improves Coronary Microcirculation and Insulin Resistance among Essential Hypertensive Patients without Left Ventricular Hypertrophy - Hypertens Res. 2008 Apr;31(4):615-22 - "Coronary flow velocity reserve (CFVR) ... CFVR was improved in the telmisartan group (2.4+/-0.4 to 2.9+/-0.4; p<0.01), but there was no difference in the nifedipine group (2.5+/-0.3 to 2.5+/-0.3; n.s.). HOMA-IR was improved in the telmisartan group (3.1+/-1.1 to 1.6+/-0.7; p<0.01), but there was no difference in the nifedipine group (2.8+/-1.1 to 2.4+/-0.7; n.s.). In conclusion, this study demonstrates that antihypertensive therapy with telmisartan, but not nifedipine, has a beneficial effect on coronary microcirculation and insulin resistance among essential hypertensive patients"
• 2-drug Blood Pressure Therapy Dramatically Lowers Cardiovascular Risk - Science Daily, 3/31/08 - "One group received a tablet containing benazepril, which is a type of drug called an ACE inhibitor, and amlodipine, which belongs to a class of drugs known as calcium channel blockers or CCBs. The other pill combined benazepril and hydrochloro-thiazide, a type of diuretic or "water pill." The 20 percent reduction in cardiovascular events was observed with the ACE/CCB combination tablet"
• Reduced incidence of new-onset atrial fibrillation with angiotensin II receptor blockade: the VALUE trial - J Hypertens. 2008 Mar;26(3):403-411 - "These findings suggest that angiotensin II receptor blockers may result in greater benefits than calcium antagonists in hypertensive patients at risk of new-onset AF"
• The development of new-onset type 2 diabetes associated with choosing a calcium channel blocker compared to a diuretic or beta-blocker - Curr Med Res Opin. 2007 Apr 23 - "Calcium channel blockers may be associated with reduced odds of developing new-onset type 2 diabetes compared to diuretics and beta-blockers" - Yeah but the odds are even less with ACE inhibitors or ARBs than with calcium channel blockers.
• One Pill May Be Better Than Two For Treating Patients With High Blood Pressure - Science Daily, 5/11/07 - "Adults with high blood pressure and additional risk factors for heart disease may benefit more from taking one tablet rather than two, if their current treatment combines the lipid-lowering medication atorvastatin with the blood pressure-lowering medication amlodipine"
• Fasting Glucose Increases in Older Adults With Hypertension Regardless of Treatment Type - Medscape, 11/16/06 - "randomized to receive treatment with chlorthalidone, amlodipine, or lisinopril to reduce blood pressure to less than 140/90 mm Hg ... During the first 2 years, the mean increase is serum glucose levels was 8.5, 5.5, and 3.5 mg/dL among the chlorthalidone, amlodipine, and lisinopril groups, respectively"
• Fasting glucose levels and incident diabetes mellitus in older nondiabetic adults randomized to receive 3 different classes of antihypertensive treatment: a report from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) - Arch Intern Med. 2006 Nov 13;166(20):2191-201 - "Mean FG levels increased during follow-up in all treatment groups. At year 2, those randomized to the chlorthalidone group had the greatest increase (+8.5 mg/dL [0.47 mmol/L] vs +5.5 mg/dL [0.31 mmol/L] for amlodipine and +3.5 mg/dL [0.19 mmol/L] for lisinopril)"
• Reduced Diabetes Likelihood in Hypertensives Starting Valsartan Treatment - Doctor's Guide, 5/18/06 - "Over a mean follow-up of 4.2 years, the risk of diabetes was 11.5% for valsartan versus 14.5% for amlodipine; the odds ratio was 0.77 in favor of valsartan"
• Diabetic Hypertensives Improve with Addition of Dihydropyridine Calcium Channel Blocker - Doctor's Guide, 5/17/06
• Effects of Valsartan Compared to Amlodipine in Prevention of Type 2 Diabetes in High-Risk Hypertensive Patients: Presented at EMH - Doctor's Guide, 6/24/05 - "Valsartan is significantly superior to amlodipine for prevention of new-onset type-2 diabetes in high-risk patients with hypertension"
• Valsartan Significant Better Than Amlodipine for Improving Long-term Heart-rate Variability in Patients With LVH: Presented at EMH - Doctor's Guide, 6/20/05
• Amlodipine and Atorvastatin Combination May Help Relax Arteries - Doctor's Guide, 5/20/05 - "the calcium channel blocker amlodipine (Norvasc) and the cholesterol-lowering agent atorvastatin (Lipitor) both reduce arterial stiffness in the small arteries ... Stiff arteries are old arteries ... Relaxing the arteries is beneficial for cardiovascular health"
• Blood Pressure Linked to Erectile Dysfunction - WebMD, 5/16/05 - "Men on older high blood pressure medications (diuretics, beta-blockers) had higher rates and more severe erectile dysfunction than men on newer medications (calcium antagonists, ACE inhibitors, angiotensin II receptor blockers)"
• Do Some Blood Pressure Drugs Up Heart Risk? - WebMD, 12/14/04 - "We found that [high-blood-pressure] therapy combinations that contain the calcium channel blockers were associated with a higher risk of death from heart disease than were other combinations"
• Amlodipine More Effective for Blood Pressure Reduction but Confers Similar Cardiac Outcomes to Valsartan Therapy - Doctor's Guide, 6/18/04
• Significant Reduction in Left Ventricular Mass Index, Reactive Oxygen Species Formation and C-Reactive Protein With Valsartan Treatment - Doctor's Guide, 6/18/04 - "Despite very similar effects on BP, there was a significantly higher reduction in LVMI with valsartan compared with amlodipine ... In the valsartan group, CRP levels were significantly reduced"
• Newer Drug Helps Prevent Heart Attack - HealthDay, 6/17/04 - "people taking valsartan had much lower rates of admission to hospital for heart failure. And fewer people in the valsartan group (13 percent) developed type 2 diabetes than those in the amlodipine group (16 percent)"
• Norvasc (Amlodipine Besylate) Appears to Achieve Superior Blood Pressure Control with Fewer Heart Attacks - Doctor's Guide, 6/16/04
• Verapamil SR Has More Favorable Impact on Mood Than Atenolol in Hypertensive Patients - Doctor's Guide, 5/25/04
• Valsartan May Produce Lower Ambulatory Heart Rate, Greater Lowering of Daytime Systolic Blood Pressure than Amlodipine in Elderly Patients with Systolic Hypertension - Doctor's Guide, 5/6/04
• Irbesartan More Effective Than Amlodipine in Reducing Left Ventricular Mass Index - Doctor's Guide, 11/4/03 - "Several studies have established that LVH is a powerful BP-independent cardiovascular risk factor; however, not all antihypertensive drugs can reverse LVH ... After 3 months, echocardiographically estimated LVMI decreased by 23.2% in the irbesartan-treated patients and 11.4% in the amlodipine-treated patients"
• Amlodipine Besylate/Benazepril HCl Combination Works Best for Lowering Blood Pressure - Doctor's Guide, 10/12/03
• Nilvadipine Lowers Low-Density Lipoprotein in Hypertensive Patients - Doctor's Guide, 10/1/03
• Eplerenone Better Tolerated and as Effective in Reducing Systolic BP Than Amlodipine - Doctor's Guide, 8/7/03
• Intranasal Nifedipine Safe in Patients With Hypertension Prior To Surgery - Doctor's Guide, 7/4/03
• Calcium Channel Blockers May Not Add to ACE Inhibition in Nondiabetic Nephropathy - Doctor's Guide, 6/12/03
• Periodic Limb Movements Increase with Isradipine, Decrease with Atenolol - Doctor's Guide, 5/21/03
• Lercandipine Effective in Treating Hypertension in Patients with Chronic Kidney Failure - Doctor's Guide, 5/21/03
• Angiotensin II Receptor Blockers Effective, Better Tolerated than Calcium Channel Blockers in Elderly Patients - Doctor's Guide, 5/21/03 - "Valsartan and amlodipine are both highly effective in controlling blood pressure in patients with isolated systolic hypertension ... However, valsartan offers a significant tolerability advantage as it shows a reduced risk of developing adverse events"
• Amlodipine Alone or in Combination with other Drugs Reduces Systolic Blood Pressure - Doctor's Guide, 5/21/03 - "The mean reduction in systolic blood pressure was approximately 17 mm Hg, while diastolic blood pressure decreased an average of 8 mm Hg, irrespective of regimen"
• Sustained-Release Isradipine Superior to Sustained-Release Amlodipine for Round-the-Clock Blood Pressure Control - Doctors' Guide, 5/20/03
• Nocturnal Dosing of Graded-Release Diltiazem Tops Nocturnal Ramipril for Blood Pressure Control - Doctor's Guide, 5/20/03
• Calcium Blockers Not Better Than Other Drug Classes - Doctor's Guide, 5/12/03
• Drugs Cut Heart Risk in Bypass Patients - HealthDay, 5/9/03
• Eplerenone As Effective As Amlodipine For Systolic Hypertension, Widened Pulse Pressure - Doctor's Guide, 4/28/03
• Once Daily Coat-Core Nifedipine Has The Advantage Over Amlodipine In Essential Hypertension - Doctor's Guide, 4/16/03
• No Differences Seen Between Calcium Channel Blocker and Beta Blocker in INVEST Trial - Doctor's Guide, 4/3/03
• Lisinopril/Nifedipine GITS Combination More Effective Than Either Drug Alone In Reducing Blood Pressure - Doctor's Guide, 4/1/03
• Nifedipine Could Be First-Line Therapy For Hypertensive Diabetics - Doctor's Guide, 3/25/03
• Cardizem LA for Hypertension - Physician's Weekly, 2/24/03
• Nisoldipine-Extended Release, Amlodipine Comparable In Safety, Efficacy For Hypertensive And Angina Therapy - Doctor's Guide, 2/20/03
• Amlodipine Appears To Provide Greater Reduction In Blood Pressure Than Does Losartan - Doctor's Guide, 2/6/03 - "Diastolic blood pressure equal to or below 90 mm Hg was achieved by 43.6% of the amlodipine patients and 42.3% of the losartan patients. Seventy-one percent of the amlodipine and 81% of the losartan patients who continued treatment with the original dose reached blood pressure goals ... However, among those patients who required dosage adjustments, a significantly higher number of amlodipine patients reached blood pressure goals. Fifty-nine percent of the amlodipine patients compared with 42%"
• Amlodipine's Antihypertensive Effect Persists Longer Than Nifedipine Gastrointestinal Therapeutic System After Missed Doses - Doctor's Guide, 2/3/03
• Blood Pressure Control -- Timing Matters - WebMD, 1/24/03 - "Researchers found that the diuretic and calcium-channel blocker were effective around the clock. The beta-blocker was the least effective of the four drugs overall and it had no effect on blood pressure during the night or in the early morning hours. ACE inhibitors actually worked best while the study participants were sleeping, but had little effect on blood pressure during the day"
• Bedtime Graded-Release Diltiazem More Effective Than Morning Administration - Doctor's Guide, 1/13/03
• Calcium Channel Blockers Differ in Long-Term Tolerability - Doctor's Guide, 12/2/02
• Diltiazem Prevents Death and Myocardial Infarction during Non-cardiac Surgery - Doctor's Guide, 11/26/02
• Incidence of Cardiac Events Similar Between Amlodipine And Irbesartan in Diabetic Patients with Overt Nephropathy - Doctor's Guide, 11/1/02
• Controlled Onset Extended Release Verapamil At Bedtime May Better Control Morning Blood Pressure, Heart Rate - Doctor's Guide, 10/9/02
• FDA Looking for Grapefruit Interactions - Doctor's Guide, 9/23/02 - "If a drug has a large first pass effect, consuming grapefruit could cause a higher drug dose to enter the bloodstream through any of these actions ... Two drugs Dr. Piazza-Hepp cited as coming recently under suspicion are amlodipine, a calcium channel blocker, and atorvastatin"
• Calcium Channel Blockers May Have Neuroprotective Effect - Doctor's Guide, 7/24/02
• Use of a Calcium Channel Blocker in Depressed Patients - Medscape, 9/18/02
• Patient Compliance with Antihypertensive Therapy Appears Longer for Those Taking Angiotensin II Antagonists - Doctor's Guide, 7/18/02 - "The researchers found that the class of drug had a statistically significant effect on the patients' persistence of compliance. Angiotensin II antagonists had the highest rate of persistence followed by ACE inhibitors, calcium channel blockers, beta-blockers, and diuretics"
• New Formulation Of Lotrel (Amlodipine/Benazepril), 10/20 mg, Now Available - Doctor's Guide, 7/15/02
• Olmesartan Medoxomil and Amlodipine Equally Effective for Mild to Moderate Hypertension - Doctor's Guide, 5/19/02
• Controlled Release Extended Release Verapamil Fails to Meet Goal in CONVINCE Trial - Doctor's Guide, 5/19/02
• Nighttime Dosing with Extended Release Diltiazem Controls Blood Pressure - Doctor's Guide, 5/19/02
• Useful Role of Chronotherapeutic Verelan PM (Verapamil) Confirmed in Multiple Subgroups - Doctor's Guide, 5/19/02
• Combination of Amlodipine/Benazepril Reduces Edema, Controls Blood Pressure After Monotherapy Failure - Doctor's Guide, 5/19/02
• Commonly Available Drugs Might Slow Progress of Age-related Dementia - Doctor's Guide, 10/8/01
• Long-term Irbesartan, Amlodipine Normalizes Resistance Artery Structure and Endothelial Function - Doctor's Guide, 9/25/01
• Scientists Find Drug [Isradipine] Helps Stop Strokes - Intelihealth, 8/20/01
• Amlodipine, Fosinopril have Equivalent Effects on Left Ventricular Hypertrophy and Urinary Albumin Excretion - Doctor's Guide, 6/20/01
• Calcium Antagonist, Lacipidine, Reduces Plaque Progression Compared To Atenolol - Doctor's Guide, 6/19/01
• Norvasc (Amlodipine Besylate) Valuable For Treating High Blood Pressure in Diabetics - Doctor's Guide, 5/22/01
• Nitrendipine Antihypertensive Does Not Negatively Affect Renal Function - Doctor's Guide, 4/3/01
• Extended Release Felodipine "Drug Holiday" Undermines Blood Pressure Control - Doctor's Guide, 4/2/01
• Nifedipine And Verapamil Differ Pharmacologically But Are Equally Effective - Doctor's Guide, 3/19/01
• Diuretics And Calcium Antagonists Best Reduce Systolic Pressure In Untreated Elderly Hypertensives - Doctor's Guide, 3/19/01 - "Initial treatment of elderly people with essential hypertension should consist of thiazide diuretics or calcium-antagonists ... These are more effective than other agents at lowering systolic blood pressure"
• Nifedipine Might Interfere With Exercise-Induced Blood Pressure Changes - Doctor's Guide, 1/30/01
• Nifedipine Linked To Male Infertility - Doctor's Guide, 9/21/99
• Major Studies Support Safety of Calcium Channel Blockers - Doctor's Guide, 11/13/96