Messerli F, Grossman E
Calcium antagonists and sympathetic activity
12th Annual ASH Meeting
Am J Hypertens
(Apr) 10:23A 1997
This is a MEDLINE-based analysis of the effects of long- and short-acting
dihydropyridine
and non-dihydropyridine CEB on HR, BP and plasma NE. The analysis shows that
all agents
lower BP acutely and chronically. SNS activity (plasma NE) increases during
both acute
and chronic treatment with short-acting CEB, both dihydropyridine and
non-dihydropyridine. During treatment with long-acting agents,
dihydropyridines did not
elevate plasma NE significantly, while non-dihydropyridines resulted in a
decline in
plasma NE.
Comment: This paper bears on the current CEB controversy. Like other
acute
vasodilators, CEB appear to increase SNS activity, and the effect appears to
be sustained,
or at least recurrent, during chronic therapy. Longer acting CEB show
significantly
different effects when divided by pharmacological type, and the suggestion in
this
abstract is that non-dihydropyridines may be preferable, a story similar to
that which is
emerging for preservation of renal function in proteinuric patients.
Obviously, the
analysis presented here probably suffers in detail from the heterogeneous
designs of the
studies included, but the directional differences of plasma NE during therapy
with
long-acting agents is probably valid. (Alan Weder, M.D., University of
Michigan)
To go back use the BACK button on your browser.
Otherwise click on the desired link to this article below:
12th Annual ASH Meeting
H: Drug therapy :
Calcium channel blockers
H: Pathophysiology :
Sympathetic nervous system