Mechanisms of action and clinical use of calcium antagonists in hypertension.
Calcium antagonists are potent arterial vasodilators that do not lead to relevant chronic sympathetic reflex activation and sodium and volume retention. This favorable hemodynamic profile renders them suitable for monotherapy of hypertension in which they can reduce the calcium influx-dependent functional component of elevated vascular resistance that may be enhanced by altered vascular muscle cation handling and increased intracellular free calcium concentrations. Clinical studies have proved their efficacy, safety, and good tolerability alone or in combination with other drugs in uncomplicated hypertension in which they are particularly effective in older, low renin, and possibly, black patients. These properties and their efficacy in the treatment of severe and accelerated hypertension or hypertensive emergencies make them a valuable addition to already available drug therapy.
Kiowski
W
W
Department of Medicine, University Hospital, Kantonsspital Basel, Switzerland.
Bolli
P
P
Erne
P
P
Müller
F B
FB
Hulthén
U L
UL
Bühler
F R
FR
D000818:Animals; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D015220:Calcium Channels / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D014655:Vascular Resistance / Q000187:drug effects
D002121:Calcium Channel Blockers; D015220:Calcium Channels