[Calcium antagonists and arterial hypertension].

The pharmacological class of calcium channel antagonists (CCA) is, with beta-adrenergic antagonists, diuretics, converting enzyme inhibitors and alpha-adrenergic antagonists, one of the first line monotherapies of essential hypertension, according to the recommendations of the "Fifth Joint National Committee on Detection, Evaluation and Treatment of Hypertension". CCA have several advantages for the treatment of hypertension: the blood pressure lowering effect is due to a reduction of total peripheral vascular resistance, which are primarily abnormally increased in hypertension; the antihypertensive efficacy of CCA is comparable to that of other commonly used antihypertensive drugs; CCA induce a significant regression of left ventricular hypertrophy, a factor of morbidity and mortality which is considered to be independent of the level of mean arterial pressure; CCA have vasodilating properties on the coronary circulation; CCA are generally well tolerated, from both clinical and biological points of view. The challenge for CCA concerns three domains related to the morbidity/mortality of hypertension (coronary and cerebrovascular events) a better antihypertensive efficacy for the whole period of 24 hours, a better prevention of cerebrovascular events and an effect on the development of atherosclerosis.