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[Calcium channel blocker]
1Department of Medicine (Hypertension and Cardiorenal Disease), Dokkyo University School of Medicine.
Insights
Long-acting calcium antagonists (CA) are widely used for coronary heart disease (CHD) and hypertension. However, their long-term effects and benefits in CHD patients require further investigation through clinical trials.
Area of Science:
- Cardiology
- Pharmacology
Context:
- Coronary heart disease (CHD) management requires balancing oxygen supply and demand.
- Calcium antagonists (CA) are popular for treating CHD and hypertension due to vasodilating and hypotensive effects.
- Short-acting CA pose risks (steal phenomenon, hypotension, sympathetic activation) in CHD.
Purpose:
- To review the current understanding of calcium antagonists in CHD treatment.
- To highlight the shift towards long-acting CA in clinical practice.
- To identify the need for further research on long-term effects of long-acting CA in CHD.
Summary:
- Long-acting calcium antagonists (CA) are preferred over short-acting agents for treating coronary heart disease (CHD) and hypertension.
- While CA offer benefits in oxygen supply augmentation and demand reduction, long-term treatment effects in CHD patients remain unclear.
- Current evidence necessitates further clinical trials to ascertain the long-term efficacy and safety of long-acting CA, including in primary prevention.
Impact:
- Informs clinical practice regarding the selection of CA for CHD and hypertension.
- Identifies knowledge gaps in the long-term management of CHD with CA.
- Guides future research directions for evaluating long-acting CA in cardiovascular disease prevention and treatment.
Abstract:
In the treatment of coronary heart disease, augmentation of oxygen supply and reduction of oxygen demand are necessary. Calcium antagonists (CA) have potent coronary vasodilating (augmentation of oxygen supply) and hypotensive (reduction of oxygen demand) effects without serious side effects, and are most popular agents in the treatment of coronary heart disease (CHD) and hypertension. Short acting CA are reported to be risks for coronary heart disease presumably due to a steal phenomenon, a marked hypotensive effect, and an increased sympathetic nerve activity. Therefore, nowadays long acting CA are usually used in the treatment of CHD and hypertension. However, long term treatment effects of long acting CA in patients with CHD are not clear. Further clinical trials (including primary prevention) concerning long acting CA are needed.