Pleiotropic effects of new generation calcium channel blockers on cardiovascular protections

Abstract

Calcium channel blockers (CCBs) are widely used to treat hypertension and generally act on L-type calcium channels. Recent studies have reported that some CCBs can also block channels belonging to other subtypes, such as N-type and T type channels. N-type calcium channels are present at sympathetic nerve terminals. T-type calcium channels are identified as an important molecular target in various organs such as the cardiac sinus node and the afferent and efferent arterioles. Blockade of N-type or T-type calcium channels resulted in reduction of glomerular capillary pressure, a stabilization of renin-angiotensin-aldosterone system and sympathetic nervous system. Therefore, the blockade of non-L-type calcium channels has unique pharmacological features of renoprotective, vascular endothelial protective, and cardioprotective effects. These new generation CCBs have special therapeutic qualities beyond their primary blood pressure lowering effects through the blocking of L-type calcium channels. The strategy for hypertension treatment with CCBs has entered a new era. We review the pleiotropic effects of CCBs on cardiovascular protections.