CALCIUM-CHANNEL ANTAGONISTS AND HYPERTENSION

The pharmacological class of calcium channel antagonists (CCA) is, with beta-adrenergic antagonists, diuretics, converting enzyme inhibitors and alpha-adrenergic antagonists, one of the first line monotherapies of essential hypertension, according fo the recommendations of the ''Fifth Joint National Committee on Detection, Evaluation and Treatment of Hypertension'': CCA have several advantages for the treatment of hypertension : the blood pressure lowering effect is due to a reduction of fetal peripheral vascular resistance, which are primarily abnormaly increased in hypertension; the antihypertensive efficacy of CCA is comparable to that of other commonly used antihypertensive drugs; CGA induce a significant regression of left ventricular hypertrophy, a factor of morbidity and mortality which is considered to be independent of the level of mean arterial pressure; CCA have vasodilating properties on the coronary circulation; CCA are generally well tolerated from both clinical and biological points of view. The challenge for CCA concerns three domains related to the morbidity/mortality of hypertension (coronary and cerebrovascular events) : a better antihypertensive efficacy for the whole period of 24 hours, a better prevention of cerebrovascular events and an effect on the development of atherosclerosis.