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Calcium Channel Blockers in the Treatment of Hypertension

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Pathophysiology and Pharmacotherapy of Cardiovascular Disease

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Abstract

Calcium channel blockers are potent and widely used antihypertensive drugs. They act by preventing calcium entry through voltage-gated calcium channels, predominantly the L-type, into cells resulting in the relaxation of vascular smooth muscle. They dilate arteries and arterioles that increase end-organ perfusion and exhibit a few adverse effects especially in the elderly hypertensive patients. The safety of calcium channel blockers is well established. Clinical trials have established non-inferiority of calcium channel blockers as compared to angiotensin-converting enzyme inhibitors, angiotensin-II AT1 receptor blockers, and diuretics for the prespecified cardiovascular endpoints. Calcium channel blockers can manifest blood pressure-independent cardiovascular protection, but this effect largely depends on their efficacy to lower blood pressure including that of central blood pressure. Calcium channel blockers are essential antihypertensive drugs to reach goal blood pressure and thus the treatment of choice (although not always the first-line agent) for most hypertensive patients, especially for the high-risk population and those with resistant hypertension. An intense treatment of hypertensive patients with adequate doses of calcium channel blockers is mandatory to improve cardiovascular prognosis. In this chapter, important clinical evidence to support the efficacy of calcium channel blockers to improve cardiovascular endpoints will be reviewed.

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Acknowledgments

We dedicate this manuscript to Professor Hiromichi Suzuki, who was our former Head of Department and one of the experts who helped establish the clinical evidence for calcium channel blockers in hypertension.

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Authors and Affiliations

  1. Department of Nephrology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku, Tokyo, 160-0023, Japan

    Yoshihiko Kanno MD

  2. Department of Nephrology, Saitama Medical University, 38 Moro-hongo Moroyama, Iruma, Saitama, 350-0495, Japan

    Yoichi Ohno MD

  3. Department of Medicine, International University of Health and Welfare, Clinical Research Center, Sanno Hospital, 8-10-16 Akasaka, Minato, Tokyo, 107-0052, Japan

    Tsuneo Takenaka MD, PhD

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  1. Yoshihiko Kanno MD
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  2. Yoichi Ohno MD
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  3. Tsuneo Takenaka MD, PhD
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Correspondence to Tsuneo Takenaka MD, PhD .

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Editors and Affiliations

  1. Center for Drug Evaluation and Research Division of Cardiovascular and Renal Products, US Food and Drug Administration, Silver Spring, Maryland, USA

    Gowraganahalli Jagadeesh

  2. Pharmacology Unit, AIMST University, Bedong, Malaysia

    Pitchai Balakumar

  3. Center for Drug Evaluation and Research Division of Cardiovascular and Renal Products, US Food and Drug Administration, Silver Spring, Maryland, USA

    Khin Maung-U

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Kanno, Y., Ohno, Y., Takenaka, T. (2015). Calcium Channel Blockers in the Treatment of Hypertension. In: Jagadeesh, G., Balakumar, P., Maung-U, K. (eds) Pathophysiology and Pharmacotherapy of Cardiovascular Disease. Adis, Cham. https://doi.org/10.1007/978-3-319-15961-4_37

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  • DOI: https://doi.org/10.1007/978-3-319-15961-4_37

  • Publisher Name: Adis, Cham

  • Print ISBN: 978-3-319-15960-7

  • Online ISBN: 978-3-319-15961-4

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