| Calcium antagonists. Clinical use in the treatment of systemic hypertension. | |
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MedLine Citation:
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PMID: 6339198 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Increased peripheral vascular resistance is the cause of elevated systemic blood pressure in most patients with long standing hypertension. The desired haemodynamic effect in antihypertensive therapy is dilation of the constricted arterioles by a drug that acts directly on the vascular smooth muscle while not affecting the heart or the venous return. Hydralazine, diazoxide and minoxidil act directly on vascular smooth muscle to produce vasodilatation and have been used with variable degrees of success in the long term treatment of hypertension. Their cellular mechanism of dilation is not understood fully, but the ability to chelate certain trace metals required for smooth muscle contraction has been proposed as a possible mechanism of action for these drugs. The calcium antagonists (calcium entry blocking drugs) are a distinct group of compounds that interfere with the normal transmembrane flux of extracellular calcium ions on which vascular tissue depends for contraction or impulse generation. Thus, calcium anti-agonists can reduce the contractile activity of the heart, and promote coronary and systemic vasodilatation. These effects provide the clinical rationale for the use of calcium antagonists in the management of ischaemic heart disease and hypertrophic cardiomyopathy. Since systemic vasodilatation can be expected to reduce elevated arterial blood pressure, interest has focused recently on calcium antagonists in the medical management of systemic hypertension. All the calcium antagonists are able, in low concentrations, to relax the smooth muscle vasculature from coronary, cerebral, mesenteric, and renal arteries. The effects on the myocardium, cardiac impulse tissue, and vascular smooth muscle are different in magnitude, however, depending on the individual agent that is used. Clinical experience in the treatment of hypertension with this class of agents is confined to verapamil, nifedipine, and diltiazem. In this article, the scientific rationale for using calcium antagonists in the treatment of arterial hypertension is explored and the clinical experiences with the different calcium antagonists used in hypertension are reviewed. |
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Authors:
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C Spivack; S Ocken; W H Frishman |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, P.H.S.; Review |
Journal Detail:
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Title: Drugs Volume: 25 ISSN: 0012-6667 ISO Abbreviation: Drugs Publication Date: 1983 Feb |
Date Detail:
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Created Date: 1983-05-27 Completed Date: 1983-05-27 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 7600076 Medline TA: Drugs Country: AUSTRALIA |
Other Details:
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Languages: eng Pagination: 154-77 Citation Subset: IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angina Pectoris
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complications Calcium Channel Blockers / therapeutic use* Diltiazem / therapeutic use Humans Hypertension / drug therapy* Nifedipine / therapeutic use Verapamil / therapeutic use |
| Grant Support | |
ID/Acronym/Agency:
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HL-00653-3/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Calcium Channel Blockers; 21829-25-4/Nifedipine; 42399-41-7/Diltiazem; 52-53-9/Verapamil |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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