MIDAS Trial Reopens Ca Channel Blocker Debate

A study which found that the calcium channel blocker isradipine may increase the risk of angina, myocardial infarction and stroke in patients with high blood pressure has fed fuel to the ongoing controversy surrounding this class of antihypertensives.

The study compared Sandoz' Dynacirc (isradipine), a twice-daily CCB, to the widely-used diuretic hydrochlorothiazide, and was published in last week's Journal of the American Medical Association.

Michele Mercuri of the Bowman Gray School of Medicine in Wisconsin and colleagues made the finding while comparing the two therapies in the treatment of carotid artery disease in hypertensive patients. Despite the controversy which has surrounded the use of short-acting CCBs in recent months (Marketletters passim), the Multicenter Isradipine Diuretic Atherosclerosis Study (MIDAS) is the first randomized controlled trial to show an increase in vascular events from one of these drugs.