Calcium channel blockers in the management of arterial hypertension

The calcium channel blockers are a new class of vasodilators that are effective in treating arterial hypertension. They may be particularly effective in black hypertensives, in the elderly, and in patients with alpha-adrenergic-mediated vasoconstriction. Three agents, nifedipine, verapamil, and diltiazem, are currently available in the United States. Nifedipine, in particular, rapidly reduces blood pressure in severe hypertension or in hypertensive urgencies. These agents have cardioprotective effects, and do not affect lipid metabolism, the pulmonary system, nor the central nervous system. As additional calcium channel blockers are developed, and as more sustained release forms become available, the current disadvantages of short duration of action and high cost should be overcome, making these agents a logical alternative choice for both initial and additive therapy of arterial hypertension.