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Calcium metabolism, calcium-channel blocking agents, and hypertension management
1Department of Pharmacology, University of Texas Health Science Center, San Antonio 78284.
Insights
Calcium metabolism disturbances may drive hypertension. Calcium-channel blockers are effective vasodilators, showing promise as a first-line treatment for selected hypertension patients.
Area of Science:
- Cardiovascular Medicine
- Cellular Biology
- Pharmacology
Background:
- Cellular calcium metabolism disturbances are implicated in essential hypertension.
- The precise role of calcium in hypertension (alleviating vs. exacerbating) remains debated.
- Variations in calcium metabolism among hypertensive individuals have been suggested.
Purpose of the Study:
- To review the role of calcium metabolism in hypertension.
- To evaluate the efficacy and potential advantages of calcium-channel blockers.
- To discuss the place of calcium-channel blockers in hypertension management.
Main Methods:
- Review of clinical studies on calcium-channel blockers in hypertension.
- Analysis of drug efficacy compared to established antihypertensive agents.
- Assessment of patient response based on demographics and renin activity.
- Evaluation of sustained-release formulations.
Main Results:
- Calcium-channel blockers are potent vasodilators that correct elevated systemic vascular resistance.
- Clinical studies demonstrate antihypertensive efficacy comparable to existing treatments.
- Specific populations, including the elderly, blacks, and those with low renin activity, respond favorably.
- Sustained-release formulations show encouraging long-term efficacy and tolerability.
Conclusions:
- Calcium-channel blockers represent a significant therapeutic option for hypertension.
- These agents may offer advantages in patients with coexisting conditions.
- Calcium-channel blockers are poised to become a first-line therapy for selected hypertensive patients.
Abstract:
Increasing evidence has suggested that a disturbance of cellular calcium metabolism may have a role in initiating and maintaining elevated systemic vascular resistance in essential hypertension. Controversy exists over whether calcium can alleviate or exacerbate the hypertensive process, and diversity of calcium metabolism in hypertensive patients has been proposed. Calcium-channel blocking agents are potent vasodilators capable of correcting the elevated systemic vascular resistance. Clinical studies have shown that these drugs have antihypertensive efficacy comparable to established agents. The elderly, blacks, and patients with low renin activity respond well to calcium-channel blockers. These drugs may also offer potential advantages over established antihypertensive agents in patients with other coexisting diseases. Sustained release formulations have been developed, and initial experience with long-term efficacy and tolerability is encouraging. The calcium-channel blockers may become first-line therapy for treatment of hypertension in selected patients.