[Calcium antagonists: current and future applications based on new evidence. Renal protective action of calcium channel blockers]

Abstract

Ca channel blockers have been widely prescribed as an antihypertensive agent in Japan, because the blood pressure (BP) lowering effect of it is strong among Japanese patients whose amount of salt intake is high and patients with chronic kidney disease (CKD) whose sodium sensitivity of BP is enhanced. In addition, it can maintain the perfusion pressure into important organs including kidneys despite lowered systemic BP, and can be used efficiently in combinations with many types of antihypertensive agents. On the other hand, most of Ca channel blockers dilate mainly preglomerular afferent arterioles, resulting in elevated glomerular capillary pressure. Therefore, renal protection by Ca channel blockers remains in debate. We will discuss the renal protective action of new Ca channel blockers, which can dilate postglomerular efferent arterioles.