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CHANNEL BLOCKER MAY HARM OLDER PEOPLE

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The use of certain types of calcium channel-blocking drugs for hypertension, or high blood pressure, in older people is being called into question by scientists at the National Institute on Aging.

Specifically, they question the use of a short-acting form of nifedipine. According to a five-year NIA study, older people taking that form of nifedipine had double the risk of death than those taking a different drug.The findings are published in the November 1995 Journal of the American Geriatrics Society. This report, the third in recent months on the risks of channel blockers, prompted the National Heart, Lung and Blood Institute to urge "great caution" in prescribing these drugs, especially at higher doses.

NIA director Richard J. Hodes stressed that the "current controversy about short-acting nifedipine should not stop doctors from treating older patients with hypertension with diuretics, beta blockers and, as necessary, long-acting calcium channel blockers or other approved medications."

He warned that patients should not stop taking any drugs without a physician's advice.

Why short-acting nifedipine is linked to higher death rates is unclear. The short-acting form must be taken several times a day and may cause detrimental changes in heart function. Doctors are continuing to study how both the long- and short-term forms of the drug work.

The NIA stressed that the first line of attack on hypertensive disease should be lifestyle and dietary changes. When people quit smoking, maintain recommended weight, exercise and stay on a low-fat, low-salt regime they have a much better chance of avoiding hypertension entirely and/or prolonging survival.