The case for calcium antagonists as first-line treatment of hypertension.
OBJECTIVE
The evidence in favour of using calcium antagonists as first-line treatment for hypertension was reviewed. Without performing a comprehensive meta-analysis, an evaluation was made of the favourable effects of these agents on cardiovascular risk factors other than the reduction in blood pressure.


BACKGROUND
Hypertension is a disease of the elderly, in whom calcium antagonists are particularly effective. These agents do not have the adverse effects on lipids or insulin resistance seen with thiazides or beta-blockers.
Promising new data show that the development of atherosclerosis can be slowed by interference with endothelial and platelet mechanisms, inhibition of vascular smooth muscle proliferation, binding of lipoproteins and hydrolysis of cholesterol esters in liposomes.


CONCLUSIONS
On the grounds of superior efficacy in the target patient population, together with favourable effects on other important factors in the genesis of atherosclerosis, calcium antagonists are the drugs of choice for first-line therapy and are also readily combined with the other major classes of antihypertensive drugs.
Bühler
F R
FR
Department of Research, University Hospitals, Kantonsspital Basel, Switzerland.
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001161:Arteriosclerosis / Q000188:drug therapy; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002319:Cardiovascular System / Q000187:drug effects*; D004232:Diuretics / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008875:Middle Aged; D012307:Risk Factors
D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004232:Diuretics