The issue of the cardiovascular safety of dihydropyridines

This review describes aspects of the calcium channel blocker controversy as it relates to hypertensive and coronary artery disease patients. Much of the controversy has occurred because of off-label use of short-acting calcium channel blockers that were never approved or recommended for use in patients with hypertension or acute myocardial infarction. A recent analysis of slow-onset, long-acting calcium channel blockers, which lack large peak-to trough fluctuations in drug levels, did not show a signal suggesting an increase in cardiovascular events.