Related Experiment Videos
Calcium antagonists and atherosclerosis
1Department of Clinical Pharmacology, Imperial College School of Medicine at St. Mary's, London, UK. M.Schachter@ic.ac.uk
Abstract:
Calcium channel blockers (CCBs) have several properties which may have beneficial effects on the development of atherosclerosis. These include inhibition of vascular smooth muscle cell (SMC) proliferation and migration; inhibition of calcium influx into the vascular wall; reduction of extracellular matrix synthesis; promotion of uptake and breakdown of low-density lipoproteins; protection of lipoproteins from oxidative modification; maintenance of endothelial cell function; inhibition of platelet activation; and reduction of blood pressure. Although some of these effects are only seen at high drug concentrations, the great majority of reports indicate that CCBs can attenuate atherogenesis in animal models, notably the cholesterol-fed rabbit. Several clinical trials have now attempted to determine the efficacy of these drugs in human atheromatous disease. The outcome of these studies, including the International Nifedipine Trial of Antiatherosclerotic Therapy (INTACT), the Montreal Nicardipine Trial, and the Multicenter Isradipine/Diuretic Atherosclerosis Study (MIDAS), are summarized in this review, in the context of trials currently in progress. The emerging evidence suggests that an antiatherosclerotic action can be demonstrated in patients but the extent and clinical importance of this effect have yet to be fully established.
Insights
Calcium channel blockers (CCBs) show potential in slowing atherosclerosis by affecting vascular smooth muscle cells and lipoproteins. Clinical trials suggest anti-atherosclerotic effects in patients, though further research is needed to confirm their clinical significance.
Area of Science:
- Cardiovascular Pharmacology
- Atherosclerosis Research
Background:
- Calcium channel blockers (CCBs) possess properties that may inhibit key processes in atherosclerosis development.
- These properties include effects on vascular smooth muscle cells, lipoprotein metabolism, and endothelial function.
Purpose of the Study:
- To review the potential anti-atherosclerotic effects of CCBs.
- To summarize outcomes of clinical trials investigating CCBs in human atheromatous disease.
Main Methods:
- Review of existing literature on CCB mechanisms and effects in animal models.
- Analysis of results from clinical trials such as INTACT, Montreal Nicardipine Trial, and MIDAS.
Main Results:
- CCBs demonstrated beneficial effects in animal models of atherogenesis.
- Clinical trials suggest a demonstrable anti-atherosclerotic action in patients, though the extent is not fully established.
Conclusions:
- Emerging evidence supports an anti-atherosclerotic role for CCBs in humans.
- Further investigation is required to fully establish the clinical importance of CCBs in managing atherosclerosis.