Henry P D
Department of Medicine, Baylor College of Medicine, Houston, Texas 77030.
J Cardiovasc Pharmacol. 1990;16 Suppl 1:S12-5.
There is evidence that calcium antagonists (calcium channel blockers) may suppress atheroma formation in animals fed high-fat diets. Studies on the antiatherosclerotic effects of calcium blockers have suggested a variety of possible mechanisms: (a) lowering of arterial pressure, (b) decrease in atherogenic plasma lipoproteins, (c) suppression of accumulation of intracellular lipids, (d) suppression of atherogenic platelet dysfunction, (e) prevention of dyslipidemic endothelial injury, (f) inhibition of chemotaxis and cell migration, (g) inhibition of cell proliferation, (h) inhibition of deposition of matrix proteins, (i) suppression of tissue mineralization, and (j) retardation of cell necrosis. Although it is tempting to ascribe the antiatherosclerotic effects of calcium blockers to a blockade of calcium channels, other possible common mechanisms of action involving low-affinity drug-binding sites must be considered. Recently, two randomized, prospective clinical trials designed to determine the effects of calcium channel blockers on the progression of coronary artery disease have been completed. Results of the trials suggest that calcium channel blockers suppressed the progression of coronary atherosclerosis. The utility of calcium channel blockers for the treatment of atherosclerosis will require further evaluation.
有证据表明，钙拮抗剂（钙通道阻滞剂）可能会抑制高脂饮食喂养动物的动脉粥样硬化形成。关于钙通道阻滞剂抗动脉粥样硬化作用的研究提出了多种可能机制：（a）降低动脉血压，（b）降低致动脉粥样硬化的血浆脂蛋白，（c）抑制细胞内脂质积累，（d）抑制致动脉粥样硬化的血小板功能障碍，（e）预防血脂异常引起的内皮损伤，（f）抑制趋化作用和细胞迁移，（g）抑制细胞增殖，（h）抑制基质蛋白沉积，（i）抑制组织矿化，以及（j）延缓细胞坏死。尽管人们很容易将钙通道阻滞剂的抗动脉粥样硬化作用归因于钙通道的阻断，但必须考虑涉及低亲和力药物结合位点的其他可能的共同作用机制。最近，两项旨在确定钙通道阻滞剂对冠状动脉疾病进展影响的随机、前瞻性临床试验已经完成。试验结果表明，钙通道阻滞剂抑制了冠状动脉粥样硬化的进展。钙通道阻滞剂在治疗动脉粥样硬化方面的效用还需要进一步评估。
