Calcium antagonists as a new treatment modality in hypertension.

The long-term vasoconstriction which is characteristic of human hypertension may be mediated by entirely different mechanisms in various hypertensive patients. In some whose hypertension is related to activation of the renin-angiotensin-aldosterone control system, appropriate antirenin therapy is effective. Recent studies indicate that calcium ions may play a special role in the etiology of low-renin essential hypertension. Specific abnormalities in calcium and magnesium metabolism which are related to deviations in the renin system have been identified. Antihypertensive therapy with calcium antagonist drugs such as nitrendipine appears to be most effective in patients with low levels of renin activity and serum ionized calcium. These observations support the concept of the heterogeneity of human hypertension and could represent a significant step towards more specific antihypertensive drug therapy.