Comments on: Which 2 drug regimen for hypertension http://www.medrants.com/archives/5262 Internal medicine, American health care, and especially medical education Sat, 11 Feb 2012 15:15:48 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Dominion Doc http://www.medrants.com/archives/5262/comment-page-1#comment-531599 Dominion Doc Wed, 10 Feb 2010 22:27:37 +0000 http://www.medrants.com/?p=5262#comment-531599 A weak, weak article.  I think that using a CCB-diuretic is a fairly non-sensical first choice combo, I think the question about CCB safety is pretty thoroughly answered.  ACCOMPLISH serves as the most recent example. A quote from an article from heartwire (link: http://bit.ly/bV4jKt):   And <b>Dr Giuseppe Mancia</b> (University of Milan-Bicocca, Monza, Italy), who is the chair of the <b>European Society of Hypertension</b> Educational Committee, commented to<b> heart</b><b><i>wire</i></b>: "What does this very small paper, which is very weak, with a few hundred patients and an uncontrolled design, add to the enormous amount of evidence we have that calcium-channel blockers are as protective as other antihypertensive drugs? Absolutely nothing, and I hope the scientific community will not take any notice of this. "The story of calcium antagonists and MI is a very old story, and this is the same group, more or less, that raised the issue in the mid-1990s based on case-control studies. Since then, a lot of water has gone under the bridge. Many, many trials and meta-analyses have disproved completely this type of evidence, which was very weak anyway," Mancia added. A weak, weak article.  I think that using a CCB-diuretic is a fairly non-sensical first choice combo, I think the question about CCB safety is pretty thoroughly answered.  ACCOMPLISH serves as the most recent example.

A quote from an article from heartwire (link: http://bit.ly/bV4jKt):
 
And Dr Giuseppe Mancia (University of Milan-Bicocca, Monza, Italy), who is the chair of the European Society of Hypertension Educational Committee, commented to heartwire: "What does this very small paper, which is very weak, with a few hundred patients and an uncontrolled design, add to the enormous amount of evidence we have that calcium-channel blockers are as protective as other antihypertensive drugs? Absolutely nothing, and I hope the scientific community will not take any notice of this.
"The story of calcium antagonists and MI is a very old story, and this is the same group, more or less, that raised the issue in the mid-1990s based on case-control studies. Since then, a lot of water has gone under the bridge. Many, many trials and meta-analyses have disproved completely this type of evidence, which was very weak anyway," Mancia added.

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