When the smoke had cleared, the two cardiologists agreed on only one thing: Millions of Americans with high blood pressure are taking costly and possibly harmful drugs with no proof they work.
A spirited debate was held last week at an American Heart Association meeting in response to a March report that the drugs, while lowering blood pressure, might increase the risks of heart attack by 60 percent.
“There have been some serious questions raised and we need to get to the bottom of it,” the heart association’s president, Dr. Sidney Smith Jr. of the University of North Carolina at Chapel Hill, told reporters before the debate. “Hypertension is a major clinical problem and it is not well treated at this time.”
The debate drew a standing-room-only crowd of more than 1,000 cardiologists to the usually sparsely attended final session of the heart association’s annual scientific meeting.
The March report triggered a huge disagreement among cardiologists over whether the drugs might actually cause harm. Last week’s debate failed to put that question to rest. But, for the first time, it drew striking agreement from some of the nation’s leading researchers that there is no evidence the drugs prevent heart disease, strokes or deaths.
Smith and four other cardiologists at the news conference agreed that while the drugs lower blood pressure, the evidence of reductions in deaths and disease is lacking.
The drugs in question, called calcium blockers, belong to one of several classes of drugs used to treat hypertension. By affecting the movement of calcium in and out of cells in blood vessels and the heart, the drugs lower blood pressure and, in theory, reduce the risk of heart attacks and strokes.
Since the March report, researchers have urged the 6 million Americans taking calcium blockers not to stop their medication without consulting their doctors. But the researchers concede those doctors won’t know how to advise their patients.
“What are our patients hearing? They’re hearing that cardiologists can’t figure out how to treat the most common disease in America,” fretted Dr. James Muller of Deaconess Hospital in Boston, who worried that the 50 million Americans with hypertension would lose faith in their physicians.
The debaters were Dr. Curt Furberg, a co-author of the March report that first raised the alarm about calcium blockers, and Dr. Franz Messerli of the Oschner Medical Clinic in New Orleans, Furberg’s most prominent critic.
The report, co-written by Dr. Bruce Psaty of the University of Washington, found that calcium blockers were associated with a 60 percent increased risk of heart attack overall.