Adalat: Historical Aspects from the Cardiologist’s View
The discovery of the principle of calcium antagonism by Reckenstein in the mid-1960s  has to be regarded as a major breakthrough especially for the therapy of ischemic heart disease. Nifedipine (Adalat), developed by Bayer Pharmaceutical Company in the mid-1960s [2, 3] was recognized by Fleckenstein as a very potent calcium antagonist soon afterwards . This first clinically applicable dihydropyridine not only proved to be very effective in protecting myocytes from calcium overload , but also in relaxing vascular smooth muscle cells through blockade of the voltage-dependent calcium channel . Hence, it became evident already in the late 1960s and early 1970s  that the drug could play an important role in the medical treatment of coronary heart disease; particularly the vasorelaxing properties became very important, as nifedipine was found to actively increase coronary flow in ischemic areas, and especially in the subendocardial layers , without disturbing autoregulation or leading to a steal phenomenon . Hence, in the late 1960s and early 1970s studies were undertaken to analyze its anti-ischemic effect in man, either by analyzing ST segment changes during exercise , or by measuring transmural coronary blood flow in ischemic areas in patients with coronary artery disease [2, 7].
KeywordsIschemic Area Historical Aspect Subendocardial Layer Vascular Smooth Muscle Tone Coronary Vasodilator Reserve
Unable to display preview. Download preview PDF.
- 2.Lichtlen PR, Ebner F (1986) Nifedipine — historical aspects. In: Lichtlen PR (ed) 6th international Adalat symposium. Exerpta Medica, Amsterdam, pp. 3–23Google Scholar
- 3.Kroneberg G (1975) Pharmacology of nifedipine (Adalat). In: Hashimoto K, Kimura E, Kobayashi T (eds) 1st international nifedipine, “Adalat” symposium. University of Tokyo Press, pp. 3–9Google Scholar
- 4.Fleckenstein A, Grün G, Byon KY et al. (1975) The basic calcium antagonistic action of nifedipine on cardiac energy metabolism and vascular smooth muscle tone. In: Hasmimoto K, Kimura E, Kubayashi T (eds) 1st international nifedipine “Adalat” symposium. University of Tokyo Press, p. 31Google Scholar
- 5.Grün G, Fleckenstein A (1972) Die elektromechanische Entkopplung der glatten Gefäßmuskulatur als Grundprinzip der Koronardilatation durch BAY 1040 — Nifedipin. Arznei-Forsch/ Drug Res 22:334Google Scholar
- 8.Kaltenbach M (1975) Assessment of antianginal substances by means of ST depression in exerise ECG. In: Hashimoto K, Kimura E, Kubayashi T (eds) 1st international nifedipine “Adalat” symposium. University of Tokyo Press, p. 126Google Scholar
- 9.Nayler WG, Dillon JS, Panagiotopoulos S, Sturrock WJ (1986) Dihydropyridines and the ischemic myocardium. In: Lichtlen PR (ed) 6th international Adalat symposium. Excerpta Medica, Amsterdam, pp 386–397Google Scholar