By P. R. Lichtlen (auth.), Professor Dr. P. R. Lichtlen, Professor Dr. A. Reale (eds.)

As little as 30 years in the past, cardiovascular learn at Bayer used to be only a small sideline with in an atmosphere ruled via chemotherapy study, and in basic terms 15 years in the past, Bayer's pharmaceutical enterprise used to be restrained to eu and Latin Ameri­ can international locations, with revenues in cardiovascular prescription drugs with regards to 0. It is going with out announcing that Adalat has replaced the corporate as a complete in its learn, improvement, and advertising, either in Germany and, most significantly, global­ huge. In examine and improvement, Adalat has led the way in which in to new parts similar to high blood pressure, acute neurology, dementia, atherosclerosis, and middle failure. In pharmacology, Adalat was once current on the dawning of the second one phar­ macological revolution, which began from entire animal versions and progres­ sed, through in vitro screening and pharmacological study at the DHP receptor, all the way down to the molecular point with the cloning of calcium-channel proteins. Having the Adalat tale heavily in its early years as a bench scientist, enable me take this chance to thank the inventors, the scientists, and the investigators who've helped to faucet the large strength of calcium-channel blockade with dihyd­ ropyridines typically and Adalat specifically. yet, good fortune are not imprecise our imaginative and prescient. there isn't any explanation for us to leisure on our laurels: it is going to take actual ideas in cardiovascular study to most sensible the most appropriate set by way of Adalat. allow us to absorb the challenge.

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Although the antihypertensive potency of calcium antagonists had been recognized by Japanese [6] and Italian clinicians [7], these agents were not extensively tested for the treatment of essential hypertension. Step care schemes with thiazide diuretics and ~-blockers were popular. Well into the 1970s, many clinicians seemed unimpressed by calcium antagonists as antihypertensive agents and some concluded that they were "not suitable for the treatment of arterial hypertension" [8]. In the course ofthel980s, however, increasing attention was paid to the adverse effects of diuretics and ~-blockers, and by the late 1980s calcium antagonists were rediscovered.

Cardiologists do not see hypertensive patients, and "hypertensologists" did not see calcium antagonists. Calcium antagonists have, however, since become very popular antihypertensive drugs used as the first step of treatment. Kidneys Our experiments with hypertensive rats have raised substantial doubts as to whether the decrease of peripheral resistance is the only or main cause of the efficacy of nifedipine in hypertensive disease. In 1982, we published the first results showing that the antihypertensive effect of calcium antagonists differs from that of vasodilators [20], mainly because of the different effects on the kidney.

Jpn Heart J 13:128-135 7. Olivari MT, Bartorelli C, Polese A, Fiorentini C, Moruzzi P, Guazzi M (1979) Treatment of hypertension with nifedipine, a calcium antagonistic agent. Circulation 59: 1056-1062 8. Pedersen OL (1978) Does verapamil have a clinically significant antihypertensive effect? Eur J Clin Pharmacol13:21-24 9. Kiowski W, Bolli MD, Erne P, Miiller FB, Hulthen UL, Biihler FR (1989) Mechanisms of action and clinical use of calcium antagonists in hypertension. Circulation 80 [Suppl. VI]: IV-136-IV-144 10.

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