In a new study, researchers found that L-type calcium channel blockers (LCCBs)—the most widely used drugs for treating high blood pressure—may harm the heart as much as help it.
They found LCCBs cause changes in blood vessels that reduce blood flow and increase pressure. They also found that LCCBs are linked to a greater risk of heart failure.
The findings suggest that care should be taken when prescribing these drugs to patients, particularly older adults and those with advanced hypertension.
The research was conducted by a team at Penn State and elsewhere.
In the United States, nearly half of all adults—or just over a hundred million—have high blood pressure, and its prevalence is increasing.
Worldwide, the condition is expected to affect 1.56 billion people by 2025.
L-type calcium channel blockers are one of the most widely prescribed drugs to treat hypertension.
But this study found that these drugs may cause the same type of damage they are intended to prevent.
The team explained that vascular smooth muscle cells (VSMCs) make up the walls of blood vessels, where they help the vessels to control blood flow by contracting and relaxing.
This activity is regulated by the concentration of calcium within the cells.
VSMCs contain numerous calcium-permeable channels to control this calcium concentration. Under conditions of hypertension, these channels allow too much calcium to enter VSMCs, which triggers the cells to undergo physiological changes, known as “remodeling,” and to divide and proliferate.
These remodeled, proliferative cells cause blood vessel walls to thicken and stiffen and blood pressure to rise.
The team says L-type calcium channel blockers were created to prevent this from happening,” said Trebak.
Yet, these drugs also simultaneously cause remodeling and proliferation of VSMCs through another mechanism.
In the study, the team used optical, electrophysiological, and molecular tools to examine smooth muscle cells in vitro and in rats.
Additionally, they examined data from the Penn State clinical database and found that incidences of heart failure were much higher in hypertensive patients treated with LCCBs than with other types of hypertension drugs.
The team says treatment with LCCBs is clinically linked to an elevated incidence of heart failure, which prompts a careful examination of the use of LCCBs during chronic hypertension where vascular remodeling is evident.
Extra care should be taken when hypertensive patients present with COVID-19, as LCCBs may exacerbate their vascular damage.
One author of the study is Mohamed Trebak, the professor of cellular and molecular physiology, Penn State.
The study is published in PNAS.
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