Future prospects for calcium antagonists.

Abstract

In hypertensive disease, calcium antagonists (CA) affect the limiting step of increased vascular resistance. In the future, it is likely that the use of calcium antagonists will be extended to the early stage of hypertension, which is characterised predominantly by preglomerular vasoconstriction and only discrete impairment of renal function. In the advanced stages of hypertension they will be used to prevent vascular remodelling and to limit renal and cardiac tissue damage. By preventing excessive calcium overload, calcium antagonists preserve tissue integrity and reverse the progression of specific vascular pathologies such as arteriosclerosis and microangiopathy through mechanisms independent of their blood pressure-lowering effect. The protective effect demonstrated by nifedipine against toxic and radiation-induced changes in nonvascular tissue in animal models merits specific attention.