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Calcium blockade in arterial hypertension. Review
Hypertension (Dallas, Tex. : 1979)
|July 1, 1983
Summary
Calcium channel blockers effectively lower blood pressure in hypertension. While generally safe, nifedipine may require combination therapy due to tolerance, and long-term human benefits on cardiovascular structure need further study.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
- Nephrology
Background:
- Arterial hypertension involves altered calcium (Ca++) roles in vascular smooth muscle.
- Calcium channel blockers exhibit enhanced vasodilatory effects in hypertensive individuals.
Purpose of the Study:
- To evaluate the efficacy and side effects of calcium channel blockers in managing arterial hypertension.
- To compare the acute and chronic effects of verapamil and nifedipine.
Main Methods:
- Acute and chronic administration of calcium channel blockers (verapamil, nifedipine).
- Monitoring of blood pressure, heart rate, plasma renin activity, and catecholamines.
- Assessment of diuretic, natriuretic, and uricosuric effects.
Main Results:
- Both verapamil and nifedipine reduce blood pressure acutely and chronically.
- Nifedipine causes more pronounced reflex increases in heart rate and catecholamines compared to verapamil.
- Acute diuretic, natriuretic, and uricosuric effects were observed.
- Tolerance to nifedipine develops with repeated administration, potentially requiring combination therapy.
Conclusions:
- Calcium channel blockers are effective antihypertensive agents.
- Nifedipine's long-term use may necessitate combination with other drugs like beta-blockers and diuretics.
- While animal studies show benefits on hypertensive cardiovascular changes, human data are still needed.