Man in't Veld A J
Department of Internal Medicine I, University Hospital Dijkzigt, Erasmus University, Rotterdam, The Netherlands.
Am J Med. 1989 Apr 17;86(4A):6-14. doi: 10.1016/0002-9343(89)90183-6.
The calcium antagonists are effective and safe agents for the treatment of arterial hypertension. They are well tolerated by the patients. In contrast to other types of antihypertensive agents, they cause few metabolic disturbances. They can be combined with diuretics, beta-blockers, and angiotensin-converting enzyme (ACE) inhibitors. They can be safely prescribed to patients with hypertension and concomitant diseases such as diabetes mellitus, chronic obstructive lung disease, congestive heart failure, gout, renal failure, peripheral atherosclerotic disease, or Raynaud's phenomenon. Dietary sodium restriction during antihypertensive therapy with calcium antagonists is not required for optimal antihypertensive efficacy. The second generation of calcium antagonists especially the dihydropyridine analogues that have greater potency and vascular selectivity, and a longer duration of action, will optimize the treatment of hypertension. Their antiatherosclerotic, antiplatelet, and "antitrophic" effects in experimental models for atherogenesis and hypertension hold great promise for the future since, so far, there has been no major success in reducing the incidence of coronary death by the treatment of hypertension.
钙拮抗剂是治疗动脉高血压的有效且安全的药物。患者对它们耐受性良好。与其他类型的抗高血压药物相比，它们引起的代谢紊乱较少。它们可与利尿剂、β受体阻滞剂和血管紧张素转换酶（ACE）抑制剂联合使用。它们可以安全地用于患有高血压及伴有糖尿病、慢性阻塞性肺疾病、充血性心力衰竭、痛风、肾衰竭、外周动脉粥样硬化疾病或雷诺现象等疾病的患者。在使用钙拮抗剂进行抗高血压治疗期间，无需限制饮食中的钠摄入即可获得最佳的抗高血压疗效。第二代钙拮抗剂，尤其是具有更强效、更高血管选择性和更长作用时间的二氢吡啶类似物，将优化高血压的治疗。它们在动脉粥样硬化形成和高血压实验模型中的抗动脉粥样硬化、抗血小板和“抗增殖”作用为未来带来了巨大希望，因为迄今为止，通过治疗高血压来降低冠心病死亡率尚未取得重大成功。
