Laurent S, Billaud E, Kreft-Jais C
Service de Pharmacologie, Hôpital Broussais, Paris.
Therapie. 1993 Nov-Dec;48 Spec No:659-64.
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.
根据“第五届全国高血压检测、评估与治疗联合委员会”的建议，钙通道拮抗剂（CCA）这一药理学类别与β-肾上腺素能拮抗剂、利尿剂、转换酶抑制剂和α-肾上腺素能拮抗剂一样，是原发性高血压的一线单药治疗方法之一。CCA在高血压治疗方面有几个优点：血压降低效果归因于总外周血管阻力的降低，而高血压时总外周血管阻力主要异常增加；CCA的降压疗效与其他常用降压药物相当；CCA能使左心室肥厚显著消退，左心室肥厚是发病率和死亡率的一个因素，被认为与平均动脉压水平无关；CCA对冠状动脉循环有血管舒张特性；从临床和生物学角度来看，CCA一般耐受性良好。CCA面临的挑战涉及与高血压发病率/死亡率相关的三个领域（冠状动脉和脑血管事件）、24小时全程更好的降压疗效、更好地预防脑血管事件以及对动脉粥样硬化发展的影响。
