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Compared with certain other L-type calcium channel blockers (for example those of the phenylalkylamine class such as verapamil) that have significant action at the heart, the dihydropyridine calcium channel blockers lower blood pressure mainly by relaxing the smooth muscle of the blood vessel walls. [3]
Calcium channel blockers (CCB), calcium channel antagonists or calcium antagonists [2] are a group of medications that disrupt the movement of calcium (Ca 2+ ) through calcium channels . [ 3 ] Calcium channel blockers are used as antihypertensive drugs , i.e., as medications to decrease blood pressure in patients with hypertension .
The L-type calcium channel (also known as the dihydropyridine channel, or DHP channel) is part of the high-voltage activated family of voltage-dependent calcium channel. [2] "L" stands for long-lasting referring to the length of activation. This channel has four isoforms: Cav1.1, Cav1.2, Cav1.3, and Cav1.4.
The parent compound is uncommon, [2] but derivatives of 1,4-dihydropyridine are important commercially and biologically. The pervasive cofactors NADH and NADPH are derivatives of 1,4-dihydropyridine. 1,4-Dihydropyridine-based drugs are L-type calcium channel blockers, used in the treatment of hypertension. 1,2-Dihydropyridines are also known ...
Age ≥55 or black: CCB ADA 2018 [11] Diabetes Diabetes with CVD risk <140/90 <130/80 ACEI/ARB, thiazide-like diuretic, and/or dihydropyridine CCB ESC / ESH 2018 [12] General age <65 General age ≥65 <130/80 <140/80 Thiazide-type diuretic, ACEI/ARB, and/or CCB CAD: add beta-blocker Resistant hypertension: add spironolactone ACC / AHA 2017 [13 ...
Antihypertensive agents comprise multiple classes of compounds that are intended to manage hypertension (high blood pressure). Antihypertensive therapy aims to maintain a blood pressure goal of <140/90 mmHg in all patients, as well as to prevent the progression or recurrence of cardiovascular diseases (CVD) in hypertensive patients with established CVD. [2]
The 8th Joint National Committee (JNC-8) recommends calcium channel blockers to be a first-line treatment either as monotherapy or in combination with thiazide-type diuretics, ACEis, or ARBs for all patients regardless of age or race. [7] The ratio of CCBs' anti-proteinuria effect, non-dihydropyridine to dihydropyridine was 30 to −2. [13]
Class IV agents are slow non-dihydropyridine calcium channel blockers. They decrease conduction through the AV node, and shorten phase two (the plateau) of the cardiac action potential. They thus reduce the contractility of the heart, so may be inappropriate in heart failure.