calcium antagonist in hypertension

Last reviewed 02/2022

Calcium antagonists are usually employed as second line agents in the treatment of hypertension. They are as effective as other hypertensive drugs when used in appropriate doses and may be, in general, used in combination with them.

Indications for the use of dihydropyridine calcium antagonists in the treatment of hypertension (1):

  • compelling indications - isolated systolic hypertension in elderly patients
  • possible indications - angina, elderly patients

Indications for the use of rate limiting calcium antagonists include (1):

  • compelling indications - angina
  • possible indications - myocardial infarction

Contraindications to the use of rate limiting calcium antagonists include (1):

  • possible contraindication - combination with beta-blockade
  • compelling contraindication - heart block, heart failure

Verapamil (or diltiazem) SHOULD NOT be combined with beta-blockade on account of it's tendency to cause heart block and impair ventricular contractility.


  • BMJ (1999), 319, 630-5.