The rationale of using calcium antagonists in the treatment of ischaemic heart disease

Journal of Clinical and Basic Cardiology 1999; 2 (2): 181-186

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Keywords: ischämische Herzerkrankung,  Kalziumantagonist,  calcium antagonist,  ischaemic heart disease

Calcium antagonists were discovered in the late 60s by Albrecht Fleckenstein and co-workers, who also solved the question of the action of calcium antagonists on the slow calcium channel. Since then, enormous developments have taken place and calcium antagonists have found a broad application in the treatment of hypertension as well as coronary heart disease. Drugs such as verapamil and nifedipine have proven useful in the long-term treatment of coronary heart disease. In particular, these drugs did not show any development of tolerance as, for example, nitrates did. Many studies have shown that calcium antagonists have a solid place in the treatment of ischaemic heart disease. They dilate coronary arteries and decrease oxygen consumption. Newer compounds in second and third generation dihydropyridines such as amlodipine, lercanidipine and lacidipine have revolutionized calcium antagonist treatment. These newer drugs do not show an effect on the cardiovascular system like early dihydropyridines did (tachycardia etc.). This article explains the rationale of using calcium antagonists in the treatment of ischaemic heart disease and the mechanisms of the principle underlying this type of treatment. J Clin Basic Cardiol 1999; 2: 181-6.