Qual(ais) o(s) antagonistas dos canais de cálcio mais indicado(s) no tratamento da hipertensão arterial?
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Data
2013
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Resumo
Pharmacological treatment of high blood pressure can
begin with any of the five main group of antihypertensive
drugs (diuretics, ace inhibitors, angiotensin receptors
blockers, calcium channel blockers and betablockers).
Among these, calcium channel blockers reduce blood
pressure mainly by decreasing periphereal vascular
resistance. They are divided in two subgroups: non
dihydropyridines (benzothiazepines and fenilalquilaminas)
and dihydropyridines. In the first subgroup are included
Verapamil and Diltiazem respectively, and in the
second Nifedipine, Felodipine, Isradipine, Nitrendipine,
Anlodipine, Lacidipine, Lercanidipine, Manidipine e
Levanlodipine. In high blood pressure treatment only
those with long term action should be used. The drugs
from the first subgroup have additional action at the
miocardium and should be used with caution. The most
usuals side effects of the calcium channel blockers are
due to periphereal vasodilation (headache, flushing and
dizziness) and other side effect often seen is malleolar
edema wich can limit its use and is not caused by fluid
retention. There are several evidences from randomized
clinical trials, meta-analysis e sistematic reviews, of the
benefits that these drugs lead in reducing blood pressure
and cardiovascular events both in monotherapy or in
association with other antihypertensive drug. The choice
between wich calcium channel blocker to be used
should be made considering the patient characteristics,
therapeutic efficacy, action duration, tolerability and
clinical experience.
Descrição
Palavras-chave
Tratamento da hipertensão, Antagonistas de cálcio, Tratamento farmacológico, Hypertension treatment, Pharmacological treatment, Calcium channel blockers
Citação
JARDIM, Paulo César Brandão Veiga; Jardim, Thiago de Souza Veiga; SOUZA, Weimar Kunz Sebba Barroso de. Quais os antagonistas dos canais de cálcio mais indicados no tratamento da hipertensão arterial? Revista Brasileira de Hipertensão, Rio de Janeiro, v. 20, n. 2, p. 78-82, 2013.