OBJECTIVES: To compare health service utilization, costs and outcomes of patients who used dihydropyridine (DHP) and non-DHP calcium channel blockers (CCB) for hypertension. METHODS: Utilizing pharmacy, membership and medical data from a large managed care health plan of over 2 million commercial members, this study included continuously enrolled patients who had at least 2 or more CCB claims (DHP or non-DHP) between Juny 2000 and June 2001 and did not have a CCB claim 6 months prior to the index claim. Patients were followed for 12 months after the index prescription and those who had drug coverage for at least 60% of the days during the follow-up period were included in the study. Geocoding using national census data was performed to extract socioeconomic data. Propensity-score matching of DHP and non-DHP group was performed to adjust for selection bias. Overall and hypertension-related pharmacy and medical service utilization and costs, and prevalence of new renal and vascular-related diagnoses during follow-up were determined for each study group. RESULTS: A total of 4443 pairs of propensity-score matched patients were included in the DHP and non-DHP study group. Prevalence of new diagnosis for ischemic cerebrovascular disease was lower in the non-DHP group than in the DHP group (1.8% vs 2.5%; p<0.05). Statistically significant difference in prevalence of new diagnosis for renal insufficiency, kidney dialysis, or proteinuria was not observed. Average hypertension-related pharmacy and medical costs were significantly lower in the non-DHP group ($168 and $260) than in the DHP group ($184 and $370; p<0.05). The inter-group difference in costs was larger among patients who used angiotensin converting enzyme inhibitors (ACEI) concurrently with CCB. CONCLUSION: Treatment of hypertension with non-DHP CCB is associated with lower prevalence of ischemic cerebrovascular disease and lower pharmacy and medical costs as compared to DHP CCBs, especially when used concurrently with ACEI.