Abstract
Traditional calcium channel blockers (CCBs) such as diltiazem, verapamil and amlodipine have been in use for various indications for many years. Newer generations of CCBs, especially the dihydropyridines, were introduced in the 1990s, with special emphasis on their lipophilicity and dual blockade of calcium channels. There is plenty of clinical evidence supporting the advantages of newer L-/T- and L-/N-type CCBs over conventional L-type CCBs. However, this evidence may be biased in many ways due to the small sample size, short follow-up and open-label design of several studies. Due to the lack of large and long-term studies, data on cardiovascular outcomes and mortality is scarce for most of the newer agents. Conversely, amlodipine has been studied in several large, long-term trials, such as the antihypertensive lipid-lowering treatment to prevent heart attack trial that enrolled >33,000 patients and had a follow-up of about 5 years. In addition, the safety and efficacy of amlodipine for enhancing patient outcomes are firmly established. Despite the limitations of current clinical evidence, the novel CCBs herald a new era in antihypertensive therapy. More well-designed, large-scale and long-term clinical trials involving these agents are needed to aid clinicians in making a more informed decision about the most appropriate CCB for their patients.
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Tiwaskar, M. (2022). Newer Calcium Channel Blockers. In: Ram, C.V.S., Teo, B.W.J., Wander, G.S. (eds) Hypertension and Cardiovascular Disease in Asia. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-030-95734-6_24
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