Calcium Channel Blockers

Original Editor - Lucinda hampton

Top Contributors - Lucinda hampton  

Introduction[edit | edit source]

CCB in a cell membrane.

Calcium channel blockers (CCBs) are used in the management of hypertension, angina pectoris, supraventricular arrhythmias, subarachnoid hemorrhage, pulmonary hypertension, and for the prevention of migraine[1].

They work by preventing calcium from entering the cells of the heart and arteries. Calcium causes the heart and arteries to contract more strongly. By blocking calcium, calcium channel blockers allow blood vessels to relax and open.

Some calcium channel blockers can also slow the heart rate, which can further lower blood pressure[2].

Categories[edit | edit source]

Conduction system.png

CCBs are often classify into two major categories, either non-dihydropyridines or dihydropyridines, based on their primary physiologic effects.

  1. The non-dihydropyridines have inhibitory effects on the sinoatrial (SA), and atrioventricular (AV) nodes resulting in a slowing of cardiac conduction and contractility. The are useful for the treatment of hypertension, reducing oxygen demand, and helps to control the rate in tachycardia.
  2. The dihydropyridines have a little direct effect on the myocardium, and instead, are more often peripheral vasodilators, and are useful for hypertension, post-intracranial hemorrhage associated vasospasm, and migraines.[3]

Adverse Effects[edit | edit source]

Ethanol blocks voltage-gated CC


  1. Non-dihydropyridines may cause constipation, worsening cardiac output, and bradycardia.
  2. Dihydropyridines may lead to lightheadedness, flushing, headaches, and peripheral edema.
  3. Alcohol, combined with a calcium channel blocker, can cause severe side effects and may also affect the way the medication works.[4]

Physiotherapy[edit | edit source]

Exercising outdoor

Exercise Capacity: CCBs do not have a major effect on exercise capacity and may help people with angina better tolerate exercise. As a result of the blood vessels throughout the body dilating, blood flow into working muscles may be decreased and the lactate threshold (the point where lactic acid begins to build up in muscles) could be reached earlier, potentially affecting athletic performance.

Other Exercise Effects: The non-dihydropyridines CCBs can reduce both resting and maximum heart rates and decrease heart rate response to exercise. They may also delay or prevent symptoms of myocardial ischemia, or reduced blood flow to the heart. For individuals using those medications, the American College of Sports Medicine recommends exercise testing to determine exercise heart rate.[5]See Physical Activity and Exercise Prescription

References[edit | edit source]

  1. Gad SC. Phthalic Anhydride. Encyclopedia of Toxicology (Third Edition). 2014 Jan 1:934-6. Available: (accessed 29.3.2022)
  2. Mayo clinic CCBs Available: (accessed 29.3.2022)
  3. McKeever RG, Hamilton RJ. Calcium channel blockers.2018 Available: 30.3.2022)
  4. Everyday health What Are Calcium Channel Blockers? Available: (accessed 30.3.2022)
  5. AZ central Calcium Channel Blockers' Effects on Exercise Capacity Available: (accessed 30.3.2022)