Conflict of Interest in the Debate over Calcium-Channel Antagonists
New England Journal of MedicinePublished 8 January 1998Open access
Henry T. Stelfox, Grace Chua, Keith O’Rourke, Allan S. Detsky
Citations620
SJR quartileQ1
SJR score19.08
SNIP13.47
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
Abstract
Our results demonstrate a strong association between authors' published positions on the safety of calcium-channel antagonists and their financial relationships with pharmaceutical manufacturers. The medical profession needs to develop a more effective policy on conflict of interest. We support complete disclosure of relationships with pharmaceutical manufacturers for clinicians and researchers who write articles examining pharmaceutical products.
Keywords
Economics, Econometrics and FinancePharmacology, Toxicology and PharmaceuticsHealth Professions
CirculationNifedipine
1,181 Citations1995Curt D. Furberg, Bruce M. Psaty +1 more
In patients with coronary disease, the use of short-acting nifedipine in moderate to high doses causes an increase in total mortality, and other calcium antagonists may have similar adverse effects, in particular those of the dihydropyridine type.
JAMAThe Risk of Myocardial Infarction Associated With Antihypertensive Drug Therapies
970 Citations1995Bruce M. Psaty
The findings of this study support the current guidelines from the Joint National Committee on the Detection, Evaluation and Treatment of High Blood Pressure that recommend diuretics and beta-blockers as first-line agents unless contraindicated, unacceptable, or not tolerated.
International Statistical ReviewStatistical Inference under Order Restrictions (The Theory and Application of Isotonic Regression)
872 Citations1973I. Vincze, R. E. Barlow +3 more
The American Journal of MedicineScientific versus commercial sources of influence on the prescribing behavior of physicians
570 Citations1982Jerry Avorn, Milton Chen +1 more
To study the relative contributions of scientific and commercial sources of information, two index drugs were chosen, whose pharmacologic effects have been shown by controlled studies to be minimal or not significantly different from those of nonprescription (over-thecounter) preparations, but which are heavily advertised as being effective.
CHEST JournalThe Effects of Pharmaceutical Firm Enticements on Physician Prescribing Patterns
385 Citations1992James P. Orlowski, Leon P. Wateska
The LancetCalcium-channel blockade and incidence of cancer in aged populations
342 Citations1996Marco Pahor, Jack M. Guralnik +6 more
Calcium-channel blockers were associated with a general increased risk of cancer in the study populations, which suggested a common mechanism.
Journal of the American Geriatrics SocietyLong‐Term Survival and Use of Antihypertensive Medications in Older Persons
274 Citations1995Marco Pahor, Jack M. Guralnik +4 more
Whether older persons with hypertension who use specific calcium antagonists and ACE inhibitors have a different risk of mortality than those using β‐blockers is investigated.
The LancetRisk of gastrointestinal haemorrhage with calcium antagonists in hypertensive persons over 67 years old
223 Citations1996M. Pahor, P. Carbonin +3 more
Calcium antagonists were associated with an increased risk of GIH in this population of hypertensive persons, and caution is needed in prescription of these agents to old patients who have other risk factors for gastrointestinal bleeding.
JAMAThe risk of myocardial infarction associated with antihypertensive drug therapies
192 Citations1995Bruce M. Psaty
JAMACalcium Channel Blockers and Myocardial Infarction
96 Citations1995Julie E. Buring
Findings from a case-control study among enrollees of the Group Health Cooperative of Puget Sound raise the possibility, but cannot evaluate definitively, whether calcium channel blockers prescribed for patients with hypertension increase risk of myocardial infarction.
New England Journal of MedicineEditorials and Conflicts of Interest
70 Citations1996Marcia Angell, Jerome P. Kassirer
In the August 29 issue of the Journal, an Original Article by Abenhaim et al., entitled “Appetite-Suppressant Drugs and the Risk of Primary Pulmonary Hypertension” dealt with the increased risk of primary pulmonary hypertension in subjects taking antiobesity drugs.
Annals of Internal MedicineCase-Control Study, Meta-analysis, and Bouillabaisse: Putting the Calcium Antagonist Scare into Context
55 Citations1995Franz H. Messerli
The recent panic over the use of calcium antagonists in cardiovascular medicine stems from a presentation of a casecontrol study at the 35th Annual Conference on Cardiovascular Disease, Epidemiology, and Prevention and a meta-analysis purporting to show a dose-related increase in mortality in patients with coronary heart disease who receive treatment with nifedipine.
JAMAChoice of initial therapy for hypertension
51 Citations1996Norman M. Kaplan
The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure recommends diet and exercise for the initial treatment of mild hypertension, followed by a diuretic or β-blocker if necessary, unless contraindicated.
PubMedFDA gives calcium channel blockers clean bill of health but warns of short-acting nifedipine hazards.
33 Citations1996Charles Marwick
Archives of Internal MedicineShould Dihydropyridines Be Used as First-Line Drugs in the Treatment of Hypertension?
32 Citations1995Curt D. Furberg
The goal in the treatment of hypertension is to reduce the increased risk of cardiovascular complications—stroke, acute myocardial infarction, congestive heart failure, and renal dysfunction—not just to lower an elevated blood pressure (BP).
Journal of HypertensionHow safe are calcium antagonists in hypertension and coronary heart disease?
26 Citations1996Giuseppe Mancia
Journal of the American Geriatrics SocietyCalcium Antagonists: Antagonists or Protagonists of Mortality in Elderly Hypertensives?
20 Citations1995Curt D. Furberg, Bruce M. Psaty
The objective of treatment of hypertension is to prevent its cardiovascular complications-stroke, acute myocardial infarction, congestive heart failure-not just to lower an elevated blood pressure.
JAMAAttitudes of internal medicine faculty and residents toward professional interaction with pharmaceutical sales representatives
20 Citations1990W. P. McKinney
JAMACalcium channel blockers and myocardial infarction. A hypothesis formulated but not yet tested
19 Citations1995J. E. Buring
The American Journal of CardiologyPrognosis of patients with unstable angina or acute myocardial infarction treated with calcium channel antagonists
16 Citations1996Roberto Ferrari
The role of calcium antagonists in the treatment of myocardial infarction is reviewed, and the differences among the 3 classes of calcium channel antagonists, phenylalkylamines, dihydropyridines, and benzothiazepines, are discussed.
The LancetAntihypertensive drugs and risk of malignant diseases
13 Citations1996Lennart Hardell, Olav Axelson +1 more
Low physical activity might be a risk factor for both hypertension and colon cancer but job-related physical activity was adjusted for in this study, and diet should be considered in future studies.
CHEST JournalAre Calcium Antagonists Harmful in Hypertensive Patients?
9 Citations1995Gabriel B. Habib
Archives of Internal MedicineCalcium antagonists and mortality. Another case of the need for clinical judgment
7 Citations1995T. C. Fagan
Archives of Internal MedicineShould dihydropyridines be used as first-line drugs in the treatment of hypertension? The con side
5 Citations1995C. D. Furberg
Cleveland Clinic Journal of MedicineAre calcium antagonists safe?
5 Citations1995R. W. Gifford
A member of the NIH committee on calcium-channel blockers gives his perspective on how studies have generated a storm of controversy.
JAMAMyocardial Infarction Associated With Antihypertensive Drug Therapy
3 Citations1996Richard S. Cooper
The major cause of the controversy is the almost complete absence of evidence from large long-term clinical trials proving that.
American Journal of Health-System PharmacyCalcium–channel blockers and risk of myocardial infarction—more hype than harm
2 Citations1995Bradley G. Phillips, Lori L. MacFarlane +1 more
Annals of Internal MedicineMeta-Analysis and Bouillabaisse
2 Citations1996William A. Ghali, Warren Y. Hershman
Clinicians should recognize and appreciate the substantial strengths of the study by Psaty and coworkers and should not dismiss its findings solely on the basis of its casecontrol design.
JAMAMyocardial infarction associated with antihypertensive drug therapy
1 Citations1996D. A. Blandino