There is a drug that has a similar mechanism of action to dihydropyridine but is less commonly used to treat blood pressure.

A friend left a message to Huazi, saying that he had a bad heart, and the doctor gave him a drug called diltiazem, which lowered his blood pressure. He asked Huazi if this drug was also a blood pressure medication, and why he rarely heard people mention it.

Huazi said that the mechanism of the drug he used was very similar to that of dihydropyridine antihypertensive drugs. Although it has a antihypertensive effect, it is mainly used to treat angina pectoris and arrhythmias. It is not as good as dihydropyridine drugs in antihypertensive effect, so it is not often used, and it should be used with caution with dihydropyridine drugs.

1. Calcium ion antagonists that are different from "dihydropyridine" Dihydropyridine drugs are familiar antihypertensive drugs, and are classified as calcium ion antagonists in pharmacology. This type of drug can inhibit the entry of calcium ions into arterial smooth muscle cells, weaken the excitability of arterial blood vessels, cause arterial dilation, and lower blood pressure. Dihydropyridine drugs have a dihydropyridine structure in their chemical structure, so they are also called dihydropyridine calcium ion antagonists.

However, there is another type of calcium ion antagonist that does not contain a dihydropyridine structure, such as diltiazem, verapamil, etc., which are called non-dihydropyridine calcium ion antagonists, or non-dihydropyridine calcium ion antagonists.

The regulatory effect of calcium ions affects both vascular smooth muscle cells and myocardial cells. Dihydropyridine drugs have high selectivity for blood vessels, so they are mainly used for antihypertensive treatment. Non-dihydropyridine calcium ion antagonists have a strong antagonistic effect on calcium ions in vascular smooth muscle cells and myocardial cells.

Non-dipine calcium ion antagonists can dilate coronary arteries to reduce resistance, increase coronary blood flow, weaken myocardial contractility, slow heart rate, and reduce cardiac oxygen consumption. Therefore, they are mainly used to prevent and treat angina pectoris in patients with coronary heart disease.

2. Characteristics of non-dipine calcium ion antagonists The adverse reactions of non-dipine calcium ion antagonists are very similar to those of dipine drugs, and may also cause symptoms such as short-term headache, palpitations, dizziness, facial flushing, lower limb edema, etc. However, the effects on heart rate are different. Non-dipine calcium ion antagonists slow down the heart rate, while dipine drugs can cause tachycardia.

It should be noted that the two types of drugs have the same pharmacological mechanism, but their selectivity for the heart and blood vessels is different. Therefore, the combined use of the two types of calcium ion channel blockers may increase adverse reactions and should be used with caution.

Because loral drugs also have the effect of lowering heart rate and reducing myocardial contractility, the two will produce a synergistic effect when used together. Caution should be exercised when using them in combination with loral drugs to avoid bradycardia.

3. Mainly used for the prevention and treatment of angina pectoris. When treating hypertension, dihydrochloride drugs are often selected because dihydrochloride drugs have high selectivity for blood vessels, less impact on the heart, longer and milder efficacy, and relatively better safety. Moreover, dihydrochloride drugs also have an inhibitory effect on the heart, which can reduce the heart's oxygen consumption and can also be used for the prevention and treatment of angina pectoris.

Non-dihydropyridine calcium ion antagonists are usually only used to treat more serious diseases such as angina pectoris and arrhythmia. For example, they are only considered when hypertension is combined with more serious coronary heart disease and angina pectoris, and dihydropyridine drugs are not suitable. Therefore, they are not used much in clinical practice and many people are not familiar with them.

To sum up, among calcium ion antagonists, there are not only dihydrochloride drugs, but also non-dihydrochloride drugs. It’s just that the former is used to treat hypertension and is well known to everyone; while the latter, although it also has a blood pressure lowering effect, is more used to treat coronary heart disease, angina pectoris, and arrhythmias, and is less used to treat hypertension. The selection and use of drugs need to be carried out under the guidance of a doctor. If you have any questions about the use of drugs, please consult a doctor or pharmacist. I am pharmacist Huazi. Welcome to follow me and share more health knowledge.