Calcium channel blockers (CCBs) decrease lower esophageal sphincter pressure,which may result in gastrointestinal disease.In a previous study,we observed an increased risk of gastrointestinal disease following treatment with CCBs in elderly patients.However,there have been few epidemiological studies in non-elderly patients to determine whether CCBs increase the risk of gastrointestinal disease.
We hypothesized that there would be greater use of antisecretory drugs,such as H2-receptor antagonists and proton pump inhibitors (PPIs),among patients prescribed CCBs and to test this hypothesis,performed a dynamic retrospective cohort study from September 2005 to August 2008 at six community pharmacies in Nagasaki Prefecture,targeting patients aged< 55 y.Correlations between initiation of treatment with antisecretory drugs and maintenance therapy with PPIs were determined by the Cox proportional hazards model.The study included 86 patients on CCBs and 93 controls not on them.During the study period,12 patients on CCBs and 6 controls started to use antisecretory drugs,for which the hazard ratio was 4.02 (95% confidence interval 1.82-10.10,P <0.001).Maintenance therapy with PPIs was commenced for 7 patients taking CCBs and 3 controls,for which the hazard ratio was 1.99 (95% confidence interval 0.52-9.42,P =0.31).These results suggest that the risk of gastrointestinal diseases could be increased by long-term treatment with CCBs in non-elderly patients.
