HOW DO CALCIUM-CHANNEL BLOCKERS PREVENT CARDIOVASCULAR EVENTS - ARE THEY ALL ALIKE

The calcium channel blockers (calcium antagonists) have vasodilatory a nd cardiodepressant effects. These pharmacological properties explain, to a large extent, the antihypertensive, antianginal, and antiarrhyth mic effects of these agents. Pharmacological differences between membe rs of this class, e.g. differences in vascular selectivity, are well d ocumented and can be exploited clinically. The efficacy of calcium cha nnel blockers in the prevention of cardiovascular events may depend on factors other than their vasodilatory and cardiodepressive effects. M uch interest, for example, has been shown in their possible antiathero sclerotic effects. It is, however, at present not possible to ascertai n how important these and other ancillary effects (such as plaque stab ilisation) are for the putative cardioprotective effects of calcium ch annel blockers. There are, moreover, few in vitro or in vivo (animal o r clinical) studies allowing valid comparison of the different calcium channel blockers with regard to these ancillary properties.