Age and antihypertensive response to calcium antagonists

Calcium antagonists are being increasingly used for the treatment of hypertension. Analysis of response patterns shows that they are particularly effective in older, low-renin and black patients. Although the reasons for this pattern are not quite clear there is evidence that the attenuated cardiovascular reflex responses may be important in these groups. Baroreflex responses are blunted in older subjects and even more so in older hypertensive patients. Patients with low-renin hypertension also show impaired sympathetic nervous system response and black subjects often have low renin levels. A diminished counter-regulatory response to the vasodilating effects of calcium antagonists may partly explain the good clinical responses of older, low-renin and black patients.