ANTIATHEROSCLEROTIC EFFECTS OF CALCIUM-ANTAGONISTS

Effects of calcium antagonists on atherosclerosis in experimental animals: A variety of calcium antagonists can inhibit the development of aortic atherosclerosis induced by marked hypercholesterolemia in cholesterol-fed animals, following mechanical injury or intoxication with vitamin D, but not in the heritable hyperlipidemic rabbit. This effect is not mediated by modifications to plasma lipids, blood pressure or other conventional risk factors. Effects of calcium antagonists on atherosclerosis in humans: It has been difficult to assess the effects of calcium antagonists on the atherogenetic process in humans. Studies on the action of calcium antagonists in the primary prevention of atherosclerosis are obviously desirable; however, they are almost impossible to perform due to the slow development of atherosclerosis and the need for long-term follow-up. Data from several clinical trials in patients with established coronary artery disease have indicated that calcium antagonists may prevent the development of new atherosclerotic plaques and may even slow the progression of established lesions. Conclusions: Present experimental and clinical evidence indicates that calcium antagonists may be able to prevent or retard the progression of atherosclerosis by mechanisms independent of and in addition to blood pressure reduction. Large long-term trials are needed to confirm this finding and to determine whether the effect is associated with a decrease in atherosclerotic morbid and fatal complications.