Newer slow- and long-acting dihydropyridine calcium antagonists offer pharmacokinetic advantages such as reduced reflex tachycardia and improved vasoselectivity for the treatment of hypertension and angina.
May support newer agents in select hypertension patients; leaves open need for outcome trials versus older dihydropyridines.
USE OF CALCIUM ANTAGONISTS: These drugs are prescribed for antihypertensive activity in patients with essential hypertension, perioperative hypertension associated with thoracic surgery, angina pectoris and for secondary prevention after acute coronary syndromes (myocardial infarction, unstable angina). ACTION OF NEWER CALCIUM ANTAGONISTS: Pharmacokinetic improvements to the original calcium antagonists have provided slow- and long-acting drugs in the dihydropyridine group, which provoke little or no reflex tachycardia. Vasoselectivity (to a certain degree) is another improvement in a few newer compounds. Some may even have a certain selectivity for particular, specialized vascular beds. SAFETY: At present it seems preferable to use the newer slow- and long-acting dihydropyridine calcium antagonists. Their long-term safety is the subject of ongoing, randomized prospective trials.
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Pieter A. van Zwieten (1996) studied this question.
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