Dihydropyridine calcium antagonists - old and new indications

Abstract

Dihydropyridine calcium antagonists have been used in clinical practice for over 20 years now. The use of short-acting dihydropyridine derivatives was associated with too abrupt blood pressure lowering and adrenergic hyperactivity with all the unfavourable sequelae. They have been replaced by long-acting derivatives, free of these effects. During the last decade, safety and efficacy of these agents were proven in a number of large clinical trials, which included many thousand patients. In this review the most prominent trials are presented. Also, the indications for dihydropyridine calcium antagonists in special populations (e.g. patients with comorbid renal disease or heart failure, the elderly, and patients receiving non-steroid antiinflammatory drugs) were briefly summarized.