Degaute J P
Clinique d'Hypertension Artérielle, Hôpital Erasme, U.L.B.
Rev Med Brux. 1998 Sep;19(4):A389-92.
Calcium antagonists have been used for treatment of cardiovascular diseases for more than 25 years. Several recent retrospective studies have suggested that chronic treatment with short-acting dihydropyridines increased the incidence of cardiac events, cancer and gastrointestinal bleedings. Randomized prospective studies have, however, never been able to confirm these observations. In addition, well-conducted studies using verapamil and diltiazem have suggested that these calcium antagonists may even improve cardiovascular mortality and morbidity of the hypertensive patient. There is therefore no reason to believe that the questionable results derived from retrospective studies of the effects of short-acting calcium antagonists on cardiac and noncardiac events may apply to the newer generation of long-acting calcium antagonists.
钙拮抗剂用于治疗心血管疾病已有25年以上。最近的几项回顾性研究表明，短效二氢吡啶类药物的长期治疗会增加心脏事件、癌症和胃肠道出血的发生率。然而，随机前瞻性研究从未能够证实这些观察结果。此外，使用维拉帕米和地尔硫䓬的精心设计的研究表明，这些钙拮抗剂甚至可能改善高血压患者的心血管死亡率和发病率。因此，没有理由相信短效钙拮抗剂对心脏和非心脏事件影响的回顾性研究所得到的有问题的结果可能适用于新一代长效钙拮抗剂。
