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Twenty-first century inherited from the twentieth-century problem - an increase in morbidity and mortality due to cardiovascular disease, of which the most common are hypertension and coronary heart disease. Modern medicine has a large and continuous augmentation arsenal of drugs to treat heart disease, with special place is occupied by calcium channel blockers.
Although the mechanism of action of calcium channel blockers is similar, their clinical effects differ significantly. First-generation drugs - verapamil, diltiazem and nifedipine, have several disadvantages: a short period, the negative effect on the contractile function of cardiac muscle, some of them slow the conduction of cardiac impulse up to dangerous bradycardia. More modern drugs do not reduce heart rate and myocardial contractility, due to their selective effect on vascular smooth muscle cells.  Recognized as a "flagship" of the third generation is amlodipine, which has the longest antihypertensive and anti-ischemic effects, and a well-studied in many clinical studies. One of the most affordable and popular drugs amlodipine - Vaskopin Farmakar company, is available in tablets of 5 mg 40 tablets per pack. After ingestion Vaskopin (Amlodipine) is slowly and almost completely absorbed from the gastrointestinal tract, and ingestion does not significantly affect its absorption. The half-life of amlodipine, in contrast to other CCBs, is longer and is 35-50 h. Constant level of amlodipine in plasma is reached after continuous use for 7-8 days. Vaskopin taken only under the supervision of a physician. Initially, he was appointed at a dose of 5 mg / day, if necessary, the daily dose of amlodipine is increased to 10 mg. In appointing Vaskopina there is a "soft" onset of action and even a persistent decrease in blood pressure within 24 hours. This provides a reliable anti-hypertensive effect during the day, especially in patients suffering from nocturnal and morning rise in blood pressure. In addition, the slow onset of action and prolonged effect Vaskopin not cause reflex stimulation of the sympathetic nervous system and heart rate (compensatory tachycardia), characteristic of earlier generations. As shown in the large multicenter trials ALLHAT and VALUE, amlodipine on blood pressure control performance is comparable with such popular drugs such as angiotensin converting enzyme inhibitors and antihypertensive drugs from a new class of valsartan. It was also noted (study THOMS), that chronic administration of amlodipine decreases the degree of hypertrophy of the left ventricular myocardium and decreases the number of associated complications. In patients with coronary artery disease, Vaskopin increases exercise tolerance, reduces the frequency of angina attacks and the need for nitroglycerin. These related to the fact that amlodipine reduces the need for "starving" in myocardial oxygen and increases coronary blood flow. As shown in the study of PREVENT, amlodipine was observed in the appointment of slowing growth of atherosclerotic plaques in the coronary and carotid arteries, and therefore, a decrease in the incidence of unstable angina by 33% and the need for operations to restore blood flow to the myocardium by 43%. According to a study CAPARES found reduction in the incidence of myocardial infarction deaths, as well as indications for repeat surgery in patients undergoing angioplasty performed coronary intervention, who were prescribed amlodipine. An important property of Vaskopina ═ it is metabolically neutral. Vaskopin chronic administration does not cause the progression of atherosclerosis than the sin of some other antihypertensive drugs may be administered to patients suffering from bronchial asthma, diabetes, gout and kidney disease. In appointing Vaskopin observed favorable for maintaining kidney function effects: increased renal blood flow, filtration and renal function. Currently in the Republic of Belarus Vaskopin been successfully applied in clinical practice. Given the high efficacy and safety, tolerability, and affordable cost of the drug, is expected to further increase its popularity among doctors and patients. References: 1. The ALLHAT Officers and Coordinators. Major outcomes in high-risk
hypertensive patients randomized to ACE inhibitor or calcium channel blocker
vs diuretic (ALLHAT). JAMA 2002; 288: 2981-2997.
2. Haria M., Wagstaff AT Amlodipine / / Drugs. - 1995. - Vol. 50, N № 3. - P. 567-584.
3. Laher MS, Kelly JG, Doyle GD et al. Pharmacokinetics of amlodipine in renal impairment / / J. Cardiovasc. Pharmacol. - 1988. - Vol. 12 (Suppl. 7). - P. S60-S63. Stelmashok Valery, MD, Department of Cardiology and Rheumatology BelMAPO
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