[Calcium channel blockers in the treatment of hypertension and ischemic coronary disease. Conflicts in their evaluation].

Calcium channel blockers represent a pharmacologically non homogenic group. Verapamil and diltiazem have myocardial component of their effect, which acts against activated sympathicus. Short acting dihydropyridines (nifedipin) appear to be harmful by patients after myocardial infarction which is caused by the reflex sympathetic response to the predominant vasodilation. In the treatment of cardiovascular disease (e.g. hypertension, coronary vascular disease) are short acting dihydropyridines not recommended. Dihydropyridines of the new generation (amlodipin, felodipin, isradipin, lacidipin, nicardipin, nimodipin, nisoldipin, nitrendipin) induce less tachycardia due to their favorable kinetic features. If the slow movement in blood or at the receptor site is not a result of molecule features there is necessary to use retarded preparations of active substance. Nevertheless, commonly used retarded preparations fulfil this requirement only incompletely. The desirable quality is provided by modern form of retardation. (e.g. GITS) only.