Purpose:
This study examines the risk of all-cause and cardiac-related mortality associated with calcium channel blockers (ccbs) and other antihypertensives/diuretics compared with beta-blockers among an elderly cohort. we explored variations in mortality risk according to ccb formulation, dose and duration of use.
Methods:
Data are from the clinical sample of the canadian study of health and aging, a population-based prospective study of community and institutional residing persons aged 65+ years. the sample comprised 837 subjects without dementia and reporting use of 1+ antihypertensive/diuretic agents at baseline (1991) and with survival data during follow-up (1996).
Results:
Risk of all-cause and cardiac-related mortality was significantly higher among nifedipine users (hr=1.85, 95%ci 1.12, 3.05 and hr=2.22, 95%ci 1.02, 4.84, respectively) compared with beta-blocker users. after adjusting for covariates, the hazard ratios (95% confidence interval) for selected drug classes compared with beta-blockers were: nifedipine hr=1.82 (1.09-3.04), diltiazem/verapamil hr=0.96 (0.58-1.60), loop diuretics hr=1.84 (1.21-2.82), ace inhibitors hr=0.98 (0.54-1.78) and other diuretics/antihypertensives hr=1.10 (0.70-1.72). among nifedipine users, mortality risk increased with average daily dose and with recent (
Conclusions:
Older subjects exposed to the dihydropyridine calcium antagonist nifedipine had a significantly higher risk for all-cause and cardiac-related mortality during the 5-year follow-up than subjects using beta-blockers. copyright (c) 2000 john wiley & sons, ltd.