Abstract

To be considered ideal for the treatment of hypertension, a class of drugs should produce a maintained reduction of arterial pressure primarily through a fall in total peripheral resistance that is at least uniformly distributed through the organ circulations of the target organs of hypertensive vascular disease. Such drugs should be useful as monotherapeutic agents, should not expand the extracellular fluid compartment, should not reflexively stimulate the heart and vessels, should reverse the structural changes in the target organs without compromising function and, of course, should be relatively free of adverse effects. As a heterogeneous class of agents, the calcium entry-blocking drugs fulfill most of these criteria, although preliminary studies suggest that their effects on organ vascular resistances and on structural cardiovascular changes are highly variable. Thus, further vigorous investigation of these new agents is highly recommended.

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