Calcium antagonists: an overview

Increased activity of calcium channels and Rho-associated kinase in the basilar artery during chronic hypertension in vivo

OBJECTIVES

Several factors mediating vascular responses appear to play an important role in the increased resistance of cerebral blood vessels during hypertension. The objective of this study was to elucidate the mechanisms by which hypertension increases the basal tone of the basilar artery in vivo.

METHODS

Using a cranial window, we examined effects of inhibitors of L-type voltage-dependent calcium channels (nicardipine) and Rho-associated kinase (Y-27632) on the baseline diameter of the basilar artery in spontaneously hypertensive rats (SHR) and compared to the responses in normotensive Wistar-Kyoto (WKY) rats.

RESULTS

Topical application of nicardipine (10(-8), 10(-7) and 10(-6) mol/l) produced dilatation of the basilar artery. Nicardipine-induced vasodilatation was enhanced in SHR compared to WKY rats. Nicardipine (10-6 mol/l) dilated the artery in WKY rats and SHR by 9 +/- 2 and 24 +/- 4%, respectively. Topical application of Y-27632 (10(-7), 10(-6) and 10(-5) mol/l) produced dilatation of the basilar artery in WKY rats in a concentration-related manner. The vasodilatation produced by Y-27632 was markedly enhanced in SHR compared to WKY rats. Y-27632 (10(-5) mol/l) dilated the artery in WKY rats and SHR by 14 +/- 2 and 45 +/- 6%, respectively. We also tested the effects of inhibitors of nitric oxide synthase (NG-nitro-l-arginine methyl ester, l-NAME), ATP-sensitive potassium channels (glibenclamide) and large-conductance calcium-activated potassium channels (tetraetyhlammonium, TEA). l-NAME and, to a lesser extent, glibenclamide produced similar constriction of the basilar artery in both strains. TEA did not affect the baseline diameter of the basilar artery in WKY rats and produced small but significant vasoconstriction in SHR.

CONCLUSIONS

These results suggest that the activity of L-type calcium channels and Rho-associated kinase is enhanced in the basilar artery during hypertensionin vivo. The enhanced contractility may contribute to the increased resistance of the basilar artery during chronic hypertension in vivo.

Comparative effect of ursodeoxycholic acid and calcium antagonists on the binding, uptake and degradation of LDL in isolated hamster hepatocytes

We have shown that ursodeoxycholic acid (UDCA) stimulates low density lipoprotein (LDL) metabolism (Biochem. J. 280 (1991) 589), as well as calcium mobilization (Am. J. Physiol. 264 (1993) G243) in isolated hepatocytes. Therefore, the effect of UDCA and that of different calcium antagonists on hepatic LDL metabolism was compared. Isolated hamster hepatocytes were incubated at 37 degrees C for 60 min in the presence of 125I-labelled hamster LDL, increasing concentrations (25-100 microM) of verapamil, nifedipine, and diltiazem, respectively, and with or without 700 microM ursodeoxycholic acid (UDCA). At concentrations up to 100 microM, neither verapamil nor nifedipine significantly affected cell associated LDL, but both agents decreased LDL degradation in a dose-dependent manner, with almost total inhibition with 100 microM of either agent. In contrast, 25 microM diltiazem stimulated LDL binding and uptake, with a maximum increase of 15-20% of control, while 50 and 100 microM diltiazem stimulated LDL degradation by 50 and 100%, respectively. UDCA increased native LDL binding and uptake by 20%, and degradation by 50%. None of the agents tested had any effect on the binding, uptake and degradation of methylated LDL. The increased hepatic LDL uptake induced by UDCA was not altered in the presence of calcium antagonists, while the increased degradation of LDL by UDCA was abolished by the addition of 50 microM of either verapamil or nifedipine. However, 100 microM diltiazem and 700 microM UDCA stimulated LDL degradation without any additive effect. These studies show that different calcium antagonists have differential effects on hepatic LDL metabolism. The similarities between the effect of diltiazem and UDCA on LDL metabolism and the absence of any additive effect, suggest that these two agents have a similar mechanism of action, which may involve the integration of both agents into the plasma membrane lipid bilayer.

Additive hypothermic effects of cocaine and nicardipine in guinea-pigs

1. This study investigated the thermoregulatory effects of cocaine combined with two reported antidotal treatments for acute cocaine overdosage, calcium channel blocker therapy and cold ambient temperatures. 2. Cocaine and nicardipine alone lowered the core temperature of female guinea-pigs (ambient temperature, 5 degrees C) which resulted in a drop in core temperature of approximately 2 degrees C at their highest respective doses (40 mg/kg and 50 mg/kg). 3. Nicardipine administration 30 min prior to cocaine caused an almost 2-fold drop in temperature (3.75 degrees C) relative to either drug alone. 4. The data suggest that cocaine and nicardipine produce hypothermia by different, but additive, mechanisms.

Calcium channel blockers in current medical practice: an update for 1993

Calcium channel blocking drugs (CCB) have been used to lower blood pressure since 1970. Three classes are currently available, the phenylalkylamines, the benzothiazepines, and the dihydropyridines. The structure of the L-type, voltage dependent calcium channel has been elucidated with molecular techniques and the different binding sites of the various CCB described. CCB have specific effects at the site of target organs. In the kidney, all classes produce natriuresis. Their action appears independent of the level of salt intake. CCB may favorably influence the course of chronic renal disease; the results of a trial comparing nifedipine to the converting enzyme inhibitor captopril showed no difference between the two drugs. CCB may impede the progression of atherosclerosis in the coronary arteries; a prospective study of nifedipine on coronary artery morphology supports this view. In the brain, nimodipine improves the outcome of patients with stroke from subarachnoid hemorrhage. Positive effects on patients with ischemic stroke have not been corroborated. CCB are approved primary treatment for patients with hypertension and are readily combined with other antihypertensive agents. They are well tolerated and have no adverse metabolic side effects. The advent of molecular pharmacology will advance current efforts to develop new CCB, which are highly selective in their site and mode of action.