Calcium channel blockers: their pharmacologic and therapeutic role in hypertension.

The prevalence of hypertension is increasing steadily in the US, particularly among African Americans. It is now clear that a large proportion of patients are inadequately controlled, with many patients requiring at least two agents to achieve their target BP. Calcium channel blockers (CCBs), comprising two subclasses--dihydropyridines and nondihydropyridines--have been for many years one of the mainstays of hypertension therapy. However, the use of CCBs as monotherapy has recently been overshadowed by the introduction of newer classes of agents such as angiotensin receptor blockers. Examining the pharmacologic and clinical effects of CCBs in essential hypertension and among specific patient groups (e.g. African Americans, patients with renal disease) paves the way for understanding why these agents are currently enjoying a resurgence in popularity as the basis for several fixed-dose combination regimens that promise to improve BP control and reduce the risk of cardiovascular events.