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September 11, 1996

Calcium Channel Blockers: Lessons Learned From MIDAS and Other Clinical Trials

Author Affiliations

From the Office of the Dean and Department of Medicine, Boston (Mass) University School of Medicine.

JAMA. 1996;276(10):829-830. doi:10.1001/jama.1996.03540100073032

Calcium channel blocking drugs have held great promise for the treatment of a variety of cardiovascular diseases, including angina pectoris, systemic and pulmonary hypertension, certain cardiac arrhythmias, and Raynaud's disease. Their popularity has increased considerably over the past decade and at present, calcium channel blockers are prescribed as frequently for hypertension as are diuretics and angiotensinconverting enzyme (ACE) inhibitors and more than β-blockers.1 However, although calcium channel blockers represent an important part of the therapeutic armamentarium against cardiovascular diseases, concerns have been raised about these drugs, particularly the short-acting dihydropyridine derivatives. The results of the Multicenter Isradipine Diuretic Atherosclerosis Study (MIDAS) reported in this issue of The Journal2 add to these concerns.

See also p 785.

MIDAS was a large, randomized, double-blind, and expensive clinical trial that compared the effects of isradipine, a short-acting dihydropyridine, and hydrochlorothiazide on the course of carotid artery disease in hypertensive patients. The