Antianginal Effects of Calcium Antagonists
The potent relaxation of vascular smooth muscle which occurs upon introduction of a calcium antagonist into either a muscle bath or when administered to a patient provides the basis for their increasing use in patients disabled by angina pectoris due to either occlusive coronary artery disease or coronary artery spasm. As discussed elsewhere in this symposium, the relative selectivity of calcium blockers for vascular smooth muscle over cardiac muscle, allows their use in therapeutic ranges with minimal negative inotropic effects. In the late 1970’s, case reports in uncontrolled studies began reporting the efficacy of calcium blockers for the treatment of coronary artery spasm.(1–5) Subsequently, it was found that these agents could be highly effective in patients with typical exertional angina as well. This paper will review the clinical applications of the calcium blockers in patients with either coronary artery spasm or exertional angina due to occlusive coronary artery disease.
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