Which medications in the drug class Calcium Channel Blockers are used in the treatment of Renovascular Hypertension?

Updated: Dec 01, 2020
  • Author: Rebecca J Schmidt, DO, FACP, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Calcium Channel Blockers

Calcium channel blockers provide control of hypertension associated with less impairment of function of the ischemic kidney. It has been suggested that they may have beneficial long-term effects, but this remains uncertain.

Calcium channel blockers inhibit influx of extracellular calcium across both myocardial and vascular smooth muscle cell membranes. Serum calcium levels remain unchanged. The resultant decrease in intracellular calcium inhibits the contractile processes of myocardial smooth muscle cells, resulting in dilation of coronary and systemic arteries and improved oxygen delivery to myocardial tissue. In addition, total peripheral resistance, systemic blood pressure, and afterload are decreased.

Diltiazem (Cardizem CD, Dilacor XR, Tiazac)

Diltiazem is similar to verapamil in that it inhibits the influx of extracellular calcium across both the myocardial and vascular smooth muscle cell membranes.

Verapamil (Calan, Verelan, Covera-HS)

During depolarization, verapamil inhibits calcium ions from entering slow channels or voltage-sensitive areas of the vascular smooth muscle and myocardium.

Nifedipine (Adalat, Procardia, Procardia XL)

Nifedipine relaxes coronary smooth muscle and produces coronary vasodilation, which, in turn, improves myocardial oxygen delivery. Sublingual administration is generally safe, despite theoretical concerns.


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