Structural changes in hypertension, the potential for their prevention, arrest and reversal: a focus on felodipine.

Hypertension is accompanied by a series of structural adaptations and pathological alterations in the heart and vessels. These include hypertrophy of the left ventricle and walls of resistance vessels, degeneration of elastic components in the walls of large arteries, atherosclerosis and glomerulosclerosis. In order to improve prognosis it is important that the antihypertensive drugs used can prevent or regress these processes, and this review focuses on the experience with the vascular selective calcium antagonist felodipine. Clinical studies show that antihypertensive treatment with felodipine promotes regression of left ventricular hypertrophy, increases compliance of large arteries, and has favourable effects on renal function. In addition, experimental data have shown that felodipine inhibits atherosclerotic plaque development. As structural cardiovascular changes appear early in hypertension, intervention with antihypertensive therapy is better initiated sooner than later. Vascular selective calcium antagonists, such as felodipine, appear effective in reducing blood pressure and in ameliorating hypertension-induced structural changes.