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Effect of calcium and calcium blockers in hypertension.

Calcium is important in the maintenance of arterial smooth muscle function and its alteration from normal may predispose to atherogenesis and hypertension. Slow channel inhibitors such as nifedipine and calcium salts have been used separately to modulate arterial calcium in patients with hypertension. This study included 41 patients with essential hypertension, of whom 29 responded to calcium gluconate therapy (9.8/6.3 mmHg) and the remaining 12 (group B) showed either no response or a rise in blood pressure. Combined administration of calcium and nifedipine in responders (29 cases, group A) in a single-blind, placebo-controlled manner showed a further substantial decrease (9.6/3.2 mmHg) in pressure compared with pressures during placebo administration in both short- as well as long-term administration in group B patients. Although it is difficult to predict the positive role of calcium in hypertension, non-obese females with increased salt intake show a greater response to calcium therapy. It is possible that calcium salts plus calcium blocker therapy can further reduce the blood pressure in a particular subset of hypertensives. However, this needs further confirmation in a larger study.