Calcium channel blockers are the strongest and most widely used antihypertensive drugs in Japan. Calcium
channel blockers dilate both artery and arteriole that increases end-organ perfusion, thus possessing few side effects
especially for the elderly hypertensive patients. The safety of calcium channel blockers was well established. In this paper,
important clinical evidence supporting the effectiveness of calcium channel blockers and improving cardiovascular
endpoints will be reviewed. Calcium channel blockers protect end-organs from hypertensive vascular injury. In addition,
calcium channel blockers show non-inferiority to angiotensin converting enzyme inhibitors, angiotensin receptor blockers
and diuretics regarding cardiovascular endpoints. Furthermore, calcium channel blockers may have superiority to betablockers.
Although cardiovascular protection by calcium channel blockers largely depends on their potent blood pressure
lowering ability, including central blood pressure, calcium channel blockers can manifest blood pressure-independent
vascular protection. Thus, calcium channel blockers are basic antihypertensive drugs, and constitute the treatment of
choice to obtain target blood pressure for most hypertensive patients, especially for high-risk population and those with
resistant hypertension. An intense treatment of hypertension with adequate doses of calcium channel blockers is
mandatory to improve cardiovascular prognosis.
Antioxidant, central hemodynamics, pulse rate, randomized clinical trial, side effect, target blood pressure.
Department of Nephrology, Saitama Medical University, 35 Moro-hongoMoroyama, Iruma Saitama 350-0495 Japan.