The Reporter: February 1997, Vol.8, No.1
Research Notes
Calcium-Channel Blocker Safe

A new calcium-channel blocker, amlodipine, does not increase the risk of death in patients with severe heart failure, according to a study published in an October 1996 issue of the New England Journal of Medicine. The PRAISE (Prospective Randomized Amlodipine Survival Evaluation) study, led by Dr. Milton Packer, the Dickinson W. Richards Professor of Medicine in circulatory physiology, director of the Heart Failure Center at CPMC, and former Irving Scholar, also found that amlodipine may be beneficial in a subgroup of heart failure patients, those with normal coronary arteries.

The PRAISE findings are important in light of ongoing controversy over the safety and efficacy of calcium-channel blockers (CCBs) widely prescribed for the treatment of hypertension and angina. CCBs have been reported to increase the risk of heart attack, stroke, cancer, congestive heart failure, and sudden death, raising fears among patients and physicians.

Dr. Packer notes, however, that those reports largely have been based on "circumstantial data," that is, retrospective, case-control studies. In the PRAISE trial, 1,153 patients with severe, chronic heart failure were randomized to receive either placebo or amlodipine for six to 33 months. The researchers concluded that amlodipine can be used with relative safety in patients with severe heart failure, although further study is under way.