There are three major classes of CCBs
(phenylalkylamines, dihydropyridines and benzothiazepines) with
different characteristics and all are effective in lowering BP. With
few exceptions, they have no undesirable metabolic effects and their
safety profile in hypertension appears good. It has been reported that
dihydropyridine CCBs are particularly effective in reducing
cerebrovascular events. They have also been shown to be effective and
safe in the treatment of isolated systolic hypertension in the elderly.
the long-term treatment of hypertension, long-acting CCBs are
preferred. Rapid onset, short-acting nifedipine should preferably be
used in combination with a beta-blocker.
Adverse effects include
initial tachycardia, headache, flushing and ankle oedema. Unlike other
CCBs, verapamil may reduce heart rate and care should be exercised when
used with beta-blockers.
The use of sublingual nifedipine should be discouraged.