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Calcium channel blockers (CCB), calcium channel antagonists or calcium antagonists [2] are a group of medications that disrupt the movement of calcium (Ca 2+ ) through calcium channels . [ 3 ] Calcium channel blockers are used as antihypertensive drugs , i.e., as medications to decrease blood pressure in patients with hypertension .
Class IV agents are slow non-dihydropyridine calcium channel blockers. They decrease conduction through the AV node , and shorten phase two (the plateau) of the cardiac action potential . They thus reduce the contractility of the heart, so may be inappropriate in heart failure.
Non-dihydropyridine calcium channel blockers such as verapamil block the slow inward calcium current in cardiac tissues, thereby having a negatively dromotropic, chronotropic and inotropic effect. [5] This (and other) pharmacological effect makes these drugs useful in the treatment of angina pectoris.
Diltiazem, sold under the brand name Cardizem among others, is a nondihydropyridine calcium channel blocker medication used to treat high blood pressure, angina, and certain heart arrhythmias. [9]
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The 8th Joint National Committee (JNC-8) recommends calcium channel blockers to be a first-line treatment either as monotherapy or in combination with thiazide-type diuretics, ACEis, or ARBs for all patients regardless of age or race. [7] The ratio of CCBs' anti-proteinuria effect, non-dihydropyridine to dihydropyridine was 30 to −2. [13]
Age ≥55 or black: CCB ADA 2018 [11] Diabetes Diabetes with CVD risk <140/90 <130/80 ACEI/ARB, thiazide-like diuretic, and/or dihydropyridine CCB ESC / ESH 2018 [12] General age <65 General age ≥65 <130/80 <140/80 Thiazide-type diuretic, ACEI/ARB, and/or CCB CAD: add beta-blocker Resistant hypertension: add spironolactone ACC / AHA 2017 [13 ...
Verapamil, sold under various trade names, [1] is a calcium channel blocker medication used for the treatment of high blood pressure, angina (chest pain from not enough blood flow to the heart), and supraventricular tachycardia. [9]