Use of calcium channel blockers and beta blockers as antihypertensives in relation to mortality in type 2 diabetes patients: a population-based observational study.

Pharmacoepidemiology and drug safety

PubMedID: 19025812

Lindberg G, Olsson J, Melander A. Use of calcium channel blockers and beta blockers as antihypertensives in relation to mortality in type 2 diabetes patients: a population-based observational study. Pharmacoepidemiol Drug Saf. 2000;9(2):127-31.
OBJECTIVES
In previous trials, patients with type 2 diabetes using calcium channel blockers (CCB) have suffered a less favourable outcome when compared with patients on other treatments. The present study was designed to compare mortality in type 2 diabetes patients using either CCB or beta blockers (BB) as antihypertensive agents.

DESIGN
Retrospective observational study. Patients were followed from the first day they were on either of the study drugs until 31 December 1996, or until death.

SETTINGS
Two Swedish municipalities.

SUBJECTS
All patients with type 2 diabetes who were using a CCB or a BB as an antihypertensive agent during 1984-1994.

MAIN OUTCOME MEASURES
Adjusted odds ratio for overall and cause-specific mortality in CCB users versus BB users.

RESULTS
Ninety-six users of CCB and 270 users of BB were included. The odds ratio for overall mortality, adjusted for age, sex, inclusion year and municipality was 1.78 (95% CI 1.17-2.71) in CCB users versus BB users. Corresponding odds ratios for mortality from IHD, stroke, cancer and other causes were 1.11, 2.41, 1.63 and 2.61, respectively. However, among those, only mortality due to other causes was significantly elevated.

CONCLUSIONS
This study adds support to the possibility of an adverse outcome in patients with diabetes using a CCB. An agent interfering with various cell functions such as calcium ion channels may also interfere with many pathways, increasing mortality. Therefore, a relation between blockade of calcium ion channels and miscellaneous causes of death should not be discarded. Our findings warrant careful examinations in other population-based studies. Copyright (c) 2000 John Wiley & Sons, Ltd.