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Doubts about another heart drug.

DOUBTS ABOUT ANOTHER HEART DRUG

Last month, we reported on a Swedish study that raised questions about the use of a popular class of heart drugs--the diuretics. Now a recent American study raises similar questions about another popular class of heart drugs--calcium channel blockers.

The sale of these drugs, also known as calcium antagonists, has been enormous ($1.2 billion in the past year in the U.S. alone and $2.5 billion worldwide). Dr. Curtis Fuberg, professor of medicine at Bowman-Gray School of Medicine in Winston-Salem, North Carolina, believes that the drug's manufacturers have not been straightforward in the claims they have made for these drugs. Dr. Furberg, who coauthored the paper with Peter Held and Salim Yusuf of the National Heart, Lung and Blood Institute in the British Medical Journal, says that they "overinterpret their findings and recommend that the drugs be used for prolonging life and reducing [cardiac] complications."

The Furberg team reviewed 22 different trials of the drugs, involving 18,000 patients who were given calcium antagonists by their doctors following heart attacks. Also reviewed were six other trials of the drugs in a total of 1,100 patients with severe chest pain of cardiac origin (angina). Although many patients felt much better when taking the drugs, the report states that the drugs were "unlikely to reduce the rate of infarct [heart attack] development, infarct size, rate of reinfarction or mortality." In other words, they were not likely to protect against further heart attack or death--claims being made by the manufacturers to the Food and Drug Administration in seeking approval for new uses of the drugs in certain groups of patients. Although the manufacturers have not made such claims in their advertising because they do not yet have FDA approval to do so, many doctors have prescribed the drugs with this possibility in mind.

Unfortunately, not only are vast sums of money being spent in the hope of achieving results that now appear unlikely, but "the data suggest a somewhat higher probability of harm than benefit," says the BMJ study. The authors also found a small increase in deaths among those treated with the drugs. Dr. Furberg says that the FDA should restrict the use of calcium antagonists during hospitalization for heart attacks by requiring appropriate warning labels on the drugs.
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Title Annotation:calcium channel blockers
Publication:Medical Update
Date:Dec 1, 1989
Words:385
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