Use of calcium antagonists in hypertension

Abstract

Calcium antagonists represent an important group of drugs for treatment of hypertension; they are effective in the whole range of severity of the disease. Dihydropyridine derivatives are most frequently used. Dihydropyridines can also be used in association with other antihypertensive drugs. Nevertheless, phenylalkylamines and benzothiazepines are contraindicated in association with beta-blocker drugs. Calcium antagonists with slow starting effect and long duration of action are the choice to be used in long-term antihypertensive treatment. This group of drugs is specially indicated in elderly patients, in hypertensive patients with diabetes mellitus and in patients with coronary heart disease. Phenylalkylamine and benzothiazepine derivatives are also used in patients with supraventricular arrhythmias. Calcium antagonists, with long duration of action due to a long half life, have the advantage to maintain antihypertensive effect for longer periods, even when patients have minor failure in antihypertensive treatment compliance. Calcium antagonists as a group of agents are as safe as diuretics, ACE-inhibitors or beta-blocking drugs in the long-term treatment of hypertension and are well tolerated.