The article is consulted professionally by Master, Dr. Nguyen Minh Son – Interventional Cardiologist – Medical Examination and Internal Medicine Department – Share99 Nha Trang International Health Hub.
Calcium channel blockers are very commonly used in the treatment of cardiovascular diseases, especially hypertension and angina. The drug has a hypoac pressure effect, fights arterial spasms, reduces heart rate, increases the period of sysentary and reduces the oxygen demand of the heart muscle.
1. What is calcium channel blocker?
Calcium channel blockers (or calcium antagonist, calcium channel blocker, abbreviated as CCB) have been applied in the treatment of cardiovascular diseases since the 70s of the twentieth century. According to many evaluation studies, the hypotension ability of this group of drugs may be comparable to ACEI inhibitors.
Calcium channel blockers have an effect on both arteries and myocardial muscles, but the effect on arteries is believed to be stronger on the heart. The drug causes rapid and strong dilation of vessels, which easily leads to rapidly decreasing blood pressure, reflexes that increase heart rate, which is not beneficial for patients with myocardial anemia. Based on the molecular structure and mechanism of action, calcium channel blockers are divided into 3 groups, including:
- Dihydropyridine (DHP): The effect is mainly on the arteries;
- Phenylalkylamine: Mainly acts on the heart muscle;
- Benzothiazepine: Works on both the heart muscle and arteries.
In particular, the dihydropyridine group is generally preferred for use in the treatment of hypertension over the other two groups (non-DHP). Some common dihydropyridine medications are:
In addition to the in addition to in additionto in addition to in the treatment of hypertension , calcium channel blockers are also prescribed in cases such as angina, arrhythmias.
2. Mechanism of effect of calcium channel blockers
2.1. For arteries
Calcium channel blockers bind to the N position on the calcium type L ion transport channel of smooth muscle cells in the artery wall, reducing the amount of calcium ions entering the cell. Decreased intthle cell calcium levels lead to a decrease in smooth muscle contraction, a decrease in vascular wall resistance, thereby reducing blood pressure and combating arterial spasms (coronary).
2.2. For myocardial muscles
CCB group drugs bind to the calcium ion transport channel of myocardial tissue cells, reducing in-cell calcium ion levels, leading to reduced contraction capacity, reduced oxygen demand of the heart muscle and reduced burden on the heart. The drug also has an effect on the automatic neurons of the heart nodes and purkinje transmission network. Specifically, they reduce the concentration of calcium ions in the cell, causing the cell membrane voltage to change, reducing the de-polarization of automatic neurons and increasing the signal transmission time in the heart. Thus, calcium channel blockers reduce heart rate, increase the period of sysentary while reducing the oxygen demand of the heart muscle. Clinically, the DHP group is highly selective with smooth muscle cells into arteries, especially with next-generation drugs that should have a therapeutic effect on hypertension and have little effect on myocardial functioning. Meanwhile, the non-DHP group of drugs is in order to treat angina due to the effect of reducing contractions, reducing the work of the heart muscle, increasing the period of sysentary, anti-coronary artery spasms. In addition, because the drug has the effect of altering the cell membrane potential, reducing the ability of the cell to self-depolarize especially for extrapolar tissue cells, it is also applied in the treatment of arrhythmias (in the atrium).
3. Typical side effects of calcium channel blockers
Calcium channel blockers can cause a number of side effects, such as:
- Headache, dizziness;
- Allergies, skin rashes;
- Flushing of the face;
- Swelling of the legs;
In some cases, some calcium channel blockers also risk reducing the patient's blood sugar levels. A few prolonged side effects will harm health.
In fact, calcium channel blockers may interact with certain medications or supplements. Therefore, patients should present to your doctor about the medications and supplements, vitamins or herbs you are taking. This will help patients minimize the risk of side effects caused by calcium antagonist.
On the other hand, when taking calcium channel blockers,patients should abstain from grapefruit beams, including fruits or juices. Grapefruit beam can interfere with the excreted process of the drug, affecting the concentration of the drug in the body. If you prefer to eat this type of food, use the drug at least 4 hours from the meal time.
4. Comparison of calcium channel blockers with other groups
Each group of drugs has different mechanisms of action, at the same time there are different benefits and disadvantages, none more than any other group. For example, the same effect of treating hypertension, but the calcium channel blocker group is superior to the beta blocker group in the prevention of stroke, however beta blockers are more than calcium blockers and other groups in the prevention of heart failure. Therefore, for patients with hypertension accompanied by other cardiovascular disease risk factors, the choice of medication should be based on the results of an assessment of these risk factors and actual clinical circumstances.
In summary, calcium channel blockers are considered safe and effective drugs for hypertension. However, due to differences in mechanism of action, pharmacokiniy and risk of side effects, the choice of cardiovascular pathology treatment option for patients will vary depending on the specific case.
Patients with hypertension or cardiovascular diseases can choose to be treated at Share99 International Health Hub. It brings together a team of cardiologistes including professors, doctors, masters, experienced specialists 2 with great prestige in the field of medical treatment, surgery, interventional cardiac capacitors. Share99 also focuses on applying advanced techniques in the diagnosis and treatment of cardiovascular diseases, using modern medical equipment system, meeting international standards.
Master – Dr. Nguyen Minh Son has many years of experience in diagnosing and treating cardiovascular diseases; especially strengths in cardiac ultrasound through the chest wall in the field of internal medicine and cardiovascular intervention. Perform other non-invasive functional probes in the diagnosis and treatment of cardiovascular diseases. Currently a doctor treated at Cardiovascular Center, Medical Examination & Internal Medicine Department, Share99 Nha Trang International Health Hub since February 2019.
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Source: Literature from The Vietnam Society of Cardiologist
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