Showing papers by "Paolo Sganzerla published in 1992"

Calcium Channel Blockade and Coronary Vasomotility in Hypertension

Abstract: Calcium channel blockers are utilized for the treatment of both coronary insufficiency and hypertension (1,2). Since many hypertensive patients have coronary artery disease, the use of these compounds to treat both disorders has been advocated (3–5). Intermittent vasomotion of restricted tracts of great epicardial branches is now recognized as an important elicitor of different forms of angina (6,7). The concept that calcium entry blockers, due to their vascular smooth muscle relaxing action, are invariably beneficial in cases in which coronary spasm or increased vascular tone threatens the perfusion of the myocardium (8), presents several exceptions. In fact, in a number of patients with double-component angina, or with the classical form, nifedipine may paradoxically constrict the stenotic tracts and be uneffective or even detrimental on anginal symptoms (9–11). Calcium antagonists are also able to importantly and rapidly lower the diastolic aortic pressure and the coronary perfusion pressure. In circumstances like these, the combination of a vasoconstrictor reaction at the level of an existing coronary restriction would be extremely undesirable.