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Abstract
Calcium-channel blockers are a distinct group of compounds that interfere with the normal transmembrane flux of extracellular calcium ions on which vascular tissue depends for contraction or impulse generation. The drugs reduce the contractile activity of the heart, and promote coronary and systemic vasodilatation. These effects provide the clinical rationale for using calcium antagonists in the management of ischemic heart disease, hypertrophic cardiomyopathy, and certain arrhythmias. Since systemic vasodilatation can be expected to reduce elevated arterial blood pressure (BP), interest has been focused on the use of the calcium-channel blockers in the medical management of systemic hypertension. In this report, we will explore the scientific rationale for use of the calcium-channel blockers in the treatment of systemic arterial hypertension and review the clinical experiences with three prototype agents: nifedipine, verapamil, and diltiazem, and two new dihydropyridine drugs, nitrendipine, and nicardipine.
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