Calcium Antagonist in Hypertension Calcium antagonists also known as calcium channel blockers are a class of drugs that blocks

the cellular entry of calcium ions through calcium channels. They are primarily used in cardiovascular disorders which act on the voltage-gated L-type calcium channels in cardiac muscle and smooth muscle of the blood vessel. Calcium channel blockers which act on heart are considered as having the negative inotropic and chronotropic effects. Calcium channel blockers cause the decrease in cardiac output due to the decrease in contractility of the cardiac muscle. Since blood pressure is determined by the cardiac output and total peripheral resistance, the effect of the calcium channel blockers can lower the blood pressure. The calcium channel blockers are categorized into dihydropyridines and nondihydropyridines. The dihydropyridines calcium channel blockers enhance the effects on vascular permeability. Their high vascular selectivity is used to reduce systemic vascular resistance and arterial pressure, which work to treat hypertension. Non-dihydopyridine calcium channel blockers consist of phenylalkylamine and benzothiazepine class of drugs. Verapamil which is in phenylalkylamine class is relatively selective for the myocardium. Diltiazem which is in benzothiazepine class is intermediate between verapamil and dihydropyridines in its selectivity for vascular calcium channels. Non-dihydropyridine calcium channel blockers can cause excessive bradycardia, impaired electrical conduction and depressed contractility and should not be administered to patients being treated with beta-blockers. Calcium channel blockers can also inhibit calcium-induced contraction of the lower esophageal sphincter, resulting in sphincter relaxation and acid reflux. (250 words)