Ishimitsu Toshihiko
Department of Hypertension and Cardiorenal Medicine, Dokkyo Medical University, Japan.
Clin Calcium. 2010 Jan;20(1):52-60.
Because epidemiological studies have indicated that the relation of blood pressure to cardiovascular risk is lineally extended to the normal blood pressure range, strict blood pressure control is desired in the antihypertensive therapy. For this purpose, combination of multiple antihypertensive drug is required in a large part of hypertensive patients. In combining antihypertensive drugs, it is preferable that the antihypertensive effects are augmented and the adverse effects are cancelled each other. Calcium channel blockers exert consistent hypotensive effects dose-dependently and scarcely cause hazardous side effects. Calcium channel blockers are preferentially used when angina pectoris and cerebrovascular disease exist, moreover, the prominent antihypertensive effects are useful as combination drugs for the treatment of diabetes mellitus and chronic renal diseases where the strict blood pressure control is strongly needed.
由于流行病学研究表明，血压与心血管风险的关系呈线性延伸至正常血压范围，因此在抗高血压治疗中需要严格控制血压。为此，大部分高血压患者需要联合使用多种抗高血压药物。在联合使用抗高血压药物时，最好能增强降压效果并相互抵消不良反应。钙通道阻滞剂具有剂量依赖性的持续降压作用，几乎不会引起有害的副作用。当存在心绞痛和脑血管疾病时，优先使用钙通道阻滞剂。此外，其显著的降压作用对于急需严格控制血压的糖尿病和慢性肾病的治疗作为联合用药很有用。
