[Does the diuretic effect of calcium inhibitors play an important role in the hypertensive efficacy?].
Calcium ions play an important role in the pathophysiology of hypertension. Calcium antagonists, a group of first line drugs in the treatment of hypertension, reduce the intracellular content of calcium in vascular smooth muscle cells, and decrease the peripheral vascular resistance and blood pressure. These drugs differ from other vasodilators in that they also have natriuretic effects; thus they can affect the kidney on three levels: Renal haemodynamics are affected by increased renal blood flow, and increased glomerular filtration rate. Changes in the renin-angiotensin system can decrease aldosterone secretion. Finally, they affect sodium management by acting directly on the renal tubule, increasing sodium excretion and inhibiting tubular reabsorption of this ion. The natriuretic effect of calcium antagonists is independent of the subject's sodium balance. The vasodilating action of these drugs is therefore accompanied by a natriuretic effect that makes satisfactory control of hypertension possible without placing the patient on a low-salt or salt-free diet.
Maldonado Martin
A
A
Service de Médecine interne, Hôpital Universitaire de Grenade, Espagne.
Gil Extremera
B
B
Rubio Luengo
M A
MA
D002118:Calcium / Q000378:metabolism* / Q000494:pharmacology; D002121:Calcium Channel Blockers / Q000494:pharmacology* / Q000627:therapeutic use; D004231:Diuresis / Q000187:drug effects*; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007668:Kidney / Q000187:drug effects* / Q000378:metabolism; D009131:Muscle, Smooth, Vascular / Q000187:drug effects; D012084:Renin-Angiotensin System / Q000187:drug effects
D002121:Calcium Channel Blockers; D002118:Calcium
L'effet diurétique des inhibiteurs calciques joue-t-il un rôle important dans l'efficacité antihypertensive?