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A review of calcium antagonists and atherosclerosis
1Division of Cardiology, Stanford University School of Medicine, California 94305-5246.
Abstract:
Many detailed studies have demonstrated that calcium antagonists can suppress development of diet-induced atherosclerosis in the thoracic aorta of animals. A number of possible mechanisms have been proposed based on in vitro work, but the exact mechanism remains unclear. Alteration of serum lipid levels and blood pressure does not appear to be the common pathway. Differing effects between calcium antagonists of different classes indicate that the voltage-dependent calcium channel-blocking action common to all calcium antagonists is not the sole mechanism. Preliminary results of several major quantitative angiographic studies in human coronary artery disease have recently become available and indicate that calcium antagonists are able to retard the progression of existing lesions in humans also. There is also evidence that calcium antagonists may prevent the development of new lesions and, in some cases, induce lesion regression. Longer follow-up and further trials are required to assess the appropriateness of widespread clinical application of these agents in coronary artery disease, to determine the optimal timing for their introduction, and to define their mechanism of action in influencing the natural history of atherosclerosis.
Insights
Calcium antagonists show promise in suppressing atherosclerosis development and retarding lesion progression in humans. Further research is needed to confirm clinical applications and understand their precise mechanisms.
Area of Science:
- Cardiovascular Research
- Pharmacology
Background:
- Calcium antagonists are known to suppress diet-induced atherosclerosis in animal models.
- The precise mechanisms underlying these effects remain incompletely understood.
- Existing evidence suggests that alterations in lipid levels or blood pressure are not the primary mechanisms.
Purpose of the Study:
- To review the evidence for calcium antagonists in atherosclerosis.
- To explore potential mechanisms of action.
- To assess their role in human coronary artery disease.
Main Methods:
- Review of in vitro studies and animal models.
- Analysis of preliminary quantitative angiographic studies in human coronary artery disease.
- Evaluation of evidence for lesion progression, prevention, and regression.
Main Results:
- Calcium antagonists can retard the progression of existing coronary artery lesions in humans.
- Evidence suggests they may also prevent new lesion development and induce regression.
- Different classes of calcium antagonists exhibit varying effects, indicating mechanisms beyond simple calcium channel blockade.
Conclusions:
- Calcium antagonists show potential in managing coronary artery disease progression.
- Further clinical trials are necessary to establish optimal use and timing.
- Defining the exact mechanism of action in atherosclerosis is crucial for clinical application.