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We read with much interest the thorough review article by Kizer and Kimmel¹ on the epidemiologic evidence on calcium antagonists. In our opinion, the paragraph addressing the "major hemorrhage" issue might convey a misguided message to the reader. In particular, our study² on the in-hospital variations in hemoglobin levels was not focused on major hemorrhage, as the outcome variable was a decrease in the hemoglobin level of greater than 1.2 g/dL. Noticeably, that study found an independent association between use of calcium antagonists and the incident decrease in hemoglobin levels among patients with a definite diagnosis and/or treatment for peptic disease (odds ratio [OR] = 1.67; 95% confidence interval [CI] = 1.26-2.22), but not among other participants (OR = 1.02; 95% CI = 0.82-1.25). These figures correspond (as Table 7 in the article by Kizer and Kimmel should have depicted adjusted relative risks [RRs]) to RRs of 1.50 (95% CI . . . [Full Text of this Article]

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RELATED ARTICLE

Epidemiologic Review of the Calcium Channel Blocker Drugs: An Up-to-date Perspective on the Proposed Hazards
Jorge R. Kizer and Stephen E. Kimmel
Arch Intern Med. 2001;161(9):1145-1158.
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