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  1. Should calcium antagonists be first-line agents in the treatment of cardiovascular disease ? The public health perspective.

    Article - En anglais

    The calcium antagonist (CA) controversy has been fueled in part by disagreements among scientists and clinicians over the scientific documentation required for drugs used to treat lifelong conditions.

    From a public health perspective, there are three unanswered questions : (I) Does long-term use of CAs convey health benefits to patients with cardiovascular disease (CVD) ? (2) Is the long-term use of CAs safe ? (3) Is the use of CAs cost effective ?

    The answers to these questions determine the pertinence of three secondary questions : (4) Do the effects of CAs reflect a class action or are there important differences in health outcomes among subclasses of CAs ? (5) Are the short-acting, immediate-release (IR) formulations different from the long-acting or the slow-release (SR) formulations ? (6) What is prudent use of CAs ?

    The purpose of this report is to summarize the answers to these questions from a public health perspective. (1) To date, use of CAs has not been documented to reduce the risks of cardiovascular complications of hypertension-stroke, myocardial infarction, congestive heart failure, or renal dysfunction. (2) The clinical trial database is inadequate to determine the long-term safety of CAs.

    The available data suggest that some formulations of CAs may be associated with an increased risk of cardiovascular and noncardiovascular events. (3) Even if slow-release CAs conveyed a benefit, their cost-effectiveness ratios are unlikely to be acceptable. (...)

    Mots-clés Pascal : Antagoniste calcium, Appareil circulatoire pathologie, Chimiothérapie, Traitement, Homme, Etats Unis, Amérique du Nord, Amérique, Coût

    Mots-clés Pascal anglais : Calcium antagonist, Cardiovascular disease, Chemotherapy, Treatment, Human, United States, North America, America, Costs

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0009221

    Code Inist : 002B02F09. Création : 21/05/1997.