Cheaper antihypertensive drugs work better than expensive calcium channel blockers, according to a new metaanalysis carried out as a joint effort by investigators at three universities in North Carolina, Seattle and New York.

The study analysed the results of nine randomised clinical trials comparing long acting calcium channel blockers with other classes of antihypertensive agents such as diuretics, beta blockers and ACE inhibitors.

In all, data from more than 27,000 patients were collected and, although calcium channel blockers were found to be as effective as other drugs in lowering blood pressure, they failed to provide the additional protection against heart attack and congestive heart failure that the cheaper antihypertensives did.

According to the lead investigator Dr Marco Pahor, from Wake Forest University in North Carolina, "The results were remarkably consistent across the trials . . . There was no difference in stroke or total mortality, and there was no evidence of differences among the calcium channel blockers tested."

While the study fell short of concluding that calcium channel blockers may be harmful, its results add to the growing body of evidence to show that they may be inferior to other available antihypertensives (BMJ; 2000; 321: 590).