VIEWPOINT The Antiatherosclerotic Effect of Calcium Antagonists in Man—What did MIDAS Actually Show?

Abstract

The Multicenter Isradipine Diuretic Atherosclerosis (MIDAS) Study was a comparison between the dihydropyridine-derived calcium antagonist isradipine and hydrochlorothiazide in 883 hypertensive patients. B-mode ultrasonography of the carotid artery was used in order to evaluate changes in wall thickness and the development of atherosclerotic plaques during a 3-year period. The final publication has yet to appear in a medical journal. However, the study and its main findings have been presented at several international scientific meetings. In brief, isradipine was significantly more effective than hydrochlorothiazide in preventing an increase in intima-media thickness at several points of measurement in the carotid artery in spite of the fact that systolic blood pressure was not as effectively lowered by isradipine as by the diuretic therapy. Since the results and their implications are of great scientific as well as clinical importance we wish to briefly comment on some of the key aspects of the MIDAS Study, as presented at some international meetings.