title: Current status of calcium antagonists in Japan.
abstract: Calcium antagonists comprise the most popular drug class for treatment of hypertension in Japan. More than half of Japanese clinicians use calcium antagonists as initial drug treatment for mild-to-moderate hypertension and, despite recent controversies, their use continues to increase. Nearly a fourth of clinicians use angiotensin-converting enzyme (ACE) inhibitors, and 9% use beta-receptor blockers. There are 12 dihydropyridine calcium antagonists and 1 benzothiazepine agent in clinical use. Amlodipine is the most widely used agent in the class. Efonidipine and cilnidipine, recently developed in Japan, both have a slow onset of action and long-lasting hypertensive effect and possess characteristics unique to the class. Efonidipine dilates the efferent as well as the afferent arterioles of the glomerulus; therefore, it appears to have a more pronounced renoprotective effect than other calcium antagonists. Cilnidipine is a dual-channel antagonist, acting on both the peripheral neuronal N-type and vascular L-type calcium channels. It depresses the pressor response to acute cold stress but does not induce tachycardia by hypotensive baroreflex.
authors.affiliation: Department of Medicine, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Saruta
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D015195:Drug Design; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007564:Japan
chemical_list: D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers