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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2003;23:2155.)
© 2003 American Heart Association, Inc.

Brief Reviews

Novel Vascular Biology of Third-Generation L-Type Calcium Channel Antagonists

Ancillary Actions of Amlodipine

R.P. Mason; P. Marche; T.H. Hintze

From the Cardiovascular Division (R.P.M), Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass, and Elucida Research (R.P.M), Beverly, Mass; CNRS UMR 7131 and University Pierre and Marie Curie (P.M), Hôpital Broussais, Paris, France; and the Department of Physiology (T.H.H.), New York Medical College, Valhalla, NY.

Correspondence to T.H. Hintze, Department of Physiology, New York Medical College, BSB, Basic Sciences Drive, Room 636, Valhalla, NY 10595. E-mail Thomas_Hintze{at}nymc.edu

Calcium channel blockers (CCBs) were developed as vasodilators, and their use in cardiovascular disease treatment remains largely based on that mechanism of action. More recently, with the evolution of second- and third-generation CCBs, pleiotropic effects have been observed, and at least some of CCBs’ benefit is attributable to these mechanisms. Understanding these effects has contributed greatly to elucidating disease mechanisms and the rationale for CCB use. Furthermore, this knowledge might clarify why drugs are useful in some disease states, such as atherosclerosis, but not in others, such as heart failure. Although numerous drugs used in the treatment of vascular disease, including statins and angiotensin-converting–enzyme inhibitors, have well-described pleiotropic effects universally accepted to contribute to their benefit, little attention has been paid to CCBs’ potentially similar effects. Accumulating evidence that at least 1 CCB, amlodipine, has pharmacologic actions distinct from L-type calcium channel blockade prompted us to investigate the pleiotropic actions of amlodipine and CCBs in general. There are several areas of research; foci here are (1) the physicochemical properties of amlodipine and its interaction with cholesterol and oxidants; (2) the mechanism by which amlodipine regulates NO production and implications; and (3) amlodipine’s role in controlling smooth muscle cell proliferation and matrix formation.

Key Words: membrane fluidity • superoxide • nitric oxide • cholesterol • smooth muscle proliferation

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