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Antihypertensive drugs and the risk of idiopathic aplastic anaemia
Author(s) -
Myers Marian Wald,
Vasilakis Catherine,
Kaufman Matthew R.,
Jick Hershel
Publication year - 2000
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1046/j.1365-2125.2000.00208.x
Subject(s) - medicine , nifedipine , odds ratio , case control study , aplastic anemia , population , pediatrics , calcium , bone marrow , environmental health
AimsA recent report has raised concern that nifedipine may be associated with an increased risk of aplastic anaemia. This large population‐based study evaluated the risk of idiopathic aplastic anaemia in users of calcium channel blockers compared with that of other antihypertensive drugs.MethodsThe study was based on information derived from the General Practice Research Database. We conducted a follow‐up study with a nested case‐control analysis of 322 448 subjects who received antihypertensive drugs. Cases were people who had a first‐time diagnosis of aplastic anaemia during January 1, 1988 through September 30, 1997. The risk estimate of aplastic anaemia was calculated for all antihypertensive drugs. For the nested case‐control analysis, six controls were matched to each case on age, sex and general practice attended. Odds ratios compared the risk of idiopathic aplastic anaemia for all antihypertensive drugs relative to nonusers.ResultsThere were 13 cases of newly diagnosed idiopathic aplastic anaemia. The estimated risk of aplastic anaemia per 100 000 users was 0.8 (95% CI 0.1, 4.7) for calcium channel blockers, 1.4 (95% CI 0.5, 4.1) for β‐adrenoceptor blockers, 2.3 (95% CI 0.6, 8.6) for angiotension‐converting enzyme (ACE) inhibitors and 5.9 (95% CI 1.6, 21.5) for users of other antihypertensive drugs. In the case‐control analysis of 13 cases and 77 controls, the odds ratio was 0.3 (95% CI 0.02, 3.3) for calcium channel blockers, 0.5 (95% CI 0.1, 2.5) for β‐adrenoceptor blockers, 0.7 (95% CI 0.1, 5.6) for ACE inhibitors, 1.2 (95% CI 0.1, 11.8) for users of other antihypertensive drugs and 0.7 (95% CI 0.1, 7.2) for users of multiple drugs with a calcium channel blocker compared with nonusers.ConclusionsThe present study suggests that the use of calcium channel blockers is not associated with an increased risk of aplastic anaemia.