Rational Pharmacotherapy in Cardiology

Advanced search


Full Text:


The efficacy of calcium antagonists widely used in cardiological practice is proved both by placebo-controlled studies and in comparative trials with end-point control. Calcium antagonists are the most effective vasoprotective medicines. In our study we had shown antihypertensive efficacy and ability to improve endothelium function of non-dihydropyridine calcium antagonist, diltiazem (Altiazem RR). Altiazem RR can be drug of choice in wide profile of patients with arterial hypertension, especially in those with concomitant metabolic abnormalities, diabetes mellitus and ischemic heart disease.

About the Author

D. V. Nebieridze
State Research center of preventive medicine of Roszdrav, Moscow
Russian Federation


1. Профилактика, диагностика и лечение артериальной гипертензии. Российские рекомендации (второй пересмотр). Кардиоваск тер профилакт 2004;(приложение):1-20.

2. Hansson L, Lindholm L, Ekbom T, et al. Randomized trial of old and new antihypertensive drugs in elderly patients: cardiovascular morbidity and mortality. The Swedish Trial in Old Patients with Hypertension￾II Study. Lancet 1999;354:1751-6.

3. Brown MJ, Palmer CR, Castaigne A, et al: Morbidity and mortality in patients randomized to double-blind treatment with a long-acting calcium-channel blocker or diuretic in the International Nifediine GITS Study: Intervention as a Goal in Hypertension Treatment (INSIGHT). Lancet 2000;356:366-72.

4. Collins R, Peto R, MacMahon S, et al. Blood pressure, stroke, and coronary heart disease. Part 2, Short-term reductions in blood pressure: overview of randomised drug trials in their epidemiological context. Lancet 1990,335:827-38.

5. HOPE study investigators. Effects of an angiotensin-convertingenzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 2000;342:145-53.

6. Estasio RO, Jeffers BW, Hiatt W, et al. The effect of nisoldipine as compared with enalapril on cardiovascular outcomes in patients with noninsulin-dependent diabetes and hypertension. ABCD Study. N Eng J Med 1998;338:645-52.

7. Kaplan NM, editor. Metabolic Aspects of Hypertension. London: Science Press Ltd., 1994.

8. Pepine CJ, Handberg EM, Cooper-DeHoff RM, et al. A calcium antagonist vs a non-calcium antagonist hypertension treatment strategy for patients with coronary artery disease. The International Verapamil-Trandolapril Study (INVEST): a randomized controlled trial. JAMA. 2003;290(21):2805-16.

9. The ALLHAT Officers and Coordinators. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002;288:2981-97.

10. Dahlof B, Devereux RB, Kjeldsen SE, et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomized trial against atenolol. Lancet 2002,359:995-1003.

11. Taddei S, Virdis A, Chiadoni L, Salvetti A. The pivotal role of endotelium in hypertension. Medicographia 1999;21(1):22-9.

12. Schiffrin EL, Hayoz D. Angiotension II Receptor Antagonists. Ed. by M. Epstein, H.R. Brunner. Philadelphia: Hanley Belfus, Inc. 2001.

13. Диагностика и лечение стабильной стенокардии. Российские рекомендации. Кардиоваск тер профилакт 2004; (приложение): 1-28.

14. Blood Pressure Lowering Treatment Trialists Collaboration . The effects of different blood-pressure-lowering regimen on major cardiovascular events: results of prospectively designed overviews of randomized trials. Lancet 2003;362:1527-35.

15. Hansson L, Hedner T, Lund-Johansen P et al. Randomised tral of ef￾fects of calcium antagonists compared with diuretics and β-blockers on cardiovascular morbidity and mortality in hypertension: the Nor￾dic Diltiazem (NORDIL) study. Lancet 2000;365:359-65.

16. Celermajer DS, Sorensen KE, Gooch VM, et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992;340:1111-5.

17. Zanchetti A, Rosei EA, Palu CD, et al. The Verapamil in Hypertension and Atherosclerosis Study (VHAS): Results of long-term randomized treatment with either verapamil or chlorthalidone on carotid intima￾media thickness. J Hypertens 1998;16:1667-76.

18. 2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens 2003;21:1011-53.

19. Julius S. Effect of sympathetic overactivity on cardiovascular prognosis in hypertension. Eur Heart J 1998;19 Suppl F:F14-8.

20. Небиеридзе Д.В., Оганов Р.Г. Гиперактивность симпатической нервной системы: клиническое значение и перспективы коррекции. Кардиоваск тер профилакт 2004;3(1):94-9.

21. Triggle DJ. Mechanisms of action of calcium channel antagonists. In: M. Epstein, editor. Calcium antagonists in clinical medicine. Philadelphia, 1998. p.1-26.

22. Марцевич С.Ю. Замедляющие пульс антагонисты кальция – роль в современной терапии сердечно-сосудистых заболеваний. РМЖ 2003;11(15):875-8.

23. Kleinbloesem CH, Van Brummelen P, Danhof M, et al. Rate of increase in the plasma concentration of nifedipine as a major determinant of its hemodynamic effects in humans. Clin Pharmacol Ther 1987;41:26-30.

24. Early treatment of unstable angina in the coronary care unit: a randomised, double blind, placebo controlled comparison of recurrent ischaemia in patients treated with nifedipine or metoprolol or both. Report of The Holland Interuniversity Nifedipine/Metoprolol Trial (HINT) Research Group. Br Heart J. 1986;56(5):400-13.

25. Waters D. Proischemic complications of dihydropyridine calcium channel blockers. Circulation 1991;84:2598-600.

26. The effect of diltiazem on mortality and reinfarction after myocardial infarction. The Multicenter Diltiazem Postinfarction Trial Research Group. N Engl J Med. 1988; 319(7): 385-92.

For citation:

Nebieridze D.V. CALCIUM ANTAGONISTS IN CLINICAL PRACTICE: FOCUS ON METABOLIC AND VASCULAR EFFECTS. Rational Pharmacotherapy in Cardiology. 2007;3(2):67-71. (In Russ.)

Views: 317

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)