Calcium-channel Blockers for Hypertension

Calcium-channel blockers, available since the late 1970s, lower blood pressure by preventing calcium from entering the arterial muscle cells. Compared to other antihypertensives, these drugs have fewer side effects but they are quite expensive. They appear to be more effective in patients who are older, black and have low renin levels.

“Calcium-channel blockers are good antihypertensive drugs too. They are also very effective against angina, so that if you’re ‘lucky’ enough to have both angina pectoris and high blood pressure, a calcium-channel blocker fits the bill. Those currently on the market. with more on the way, are nifedipine, nicardipine, verapamil, diltiazem and isradipine. Although they all lower blood pressure by dilating the arteries, these agents are not interchangeable because each has certain specific characteristics that may be good for one person and not for another,” according to Dr. Isadore Rosenfeld of the New York Hospital – Memorial Sloan – Kettering Cancer Center in “The Best Treatment.”

“Their side effects include constipation, dry mouth, nausea, cramps and in rare instances impotence. Nifedipine and related drugs are especially likely to cause heart palpitations and swelling of one or both feet and ankles. Constipation is more of a problem with verapamil. Like most other drugs, any of these agents can cause a rash,” warned Rosenfeld.

While we’re at it, we might as well discuss other treatments for hypertension. Prazosin, terazosin and doxazosin belong to a class of drugs called vasodilators. They act by relaxing the muscle tissues of the blood vessels, widening them so that blood pressure is reduced. These drugs don’t work well alone but are often combined with a diuretic or beta-blocker.

Of the three, prazosin is safer. Terazosin, in particular, can raise blood cholesterol levels, making things worse for you. All vasodilators, however, can make your world go round.

“The very first time you take them, they can make you dizzy and even cause you to faint, especially when you stand up suddenly from the lying position. So always start treatment with any of these agents at bedtime, and let your doctor know if they leave you lightheaded or feeling faint before you take a second dose,” Rosenfeld said.

Reserpine was once widely used during the early days of hypertension treatment. It controls the condition by depleting certain chemicals in the nervous system which maintain blood pressure.

But its side effects read like a grocery list – abdominal pain, constipation, loss of sexual desire, nausea and vomiting among others. Today’s hypertensive patient is better off with other new drugs in the market.

“One medication I absolutely shun is reserpine. It was widely used years ago when there was little else available to reduce blood pressure. However, it also affects nerves in the brain, and causes severe depression that can be prolonged and life-threatening, especially in older persons,” Rosenfeld concluded. (Next: The role of ACE inhibitors in hypertension,)

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Additional reading:

1. Beta-blockers for Hypertension
   
     Beta-blockers are drugs which block the effects of adrenaline and other hormones that stimulate the heart and cause blood pressure to rise. They have been available since the 1960s and are being prescribed for a...


2. Calcium and Magnesium For High Blood Pressure
   
   Calcium and magnesium are both essential minerals that the body needs. They are two of the minerals contained in each of the body cells, hence calcium and magnesium can contribute to the occurrence of high blood pressure....