Qual(ais) o(s) antagonistas dos canais de cálcio mais indicado(s) no tratamento da hipertensão arterial?

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.