Calcium channel blockers (CCB), calcium channel antagonists or calcium antagonists are a group of medications that disrupt the movement of calcium () through calcium channels. Calcium channel blockers are used as antihypertensive drugs, i.e., as medications to decrease blood pressure in patients with hypertension. CCBs are particularly effective against large vessel stiffness, one of the common causes of elevated systolic blood pressure in elderly patients. Calcium channel blockers are also frequently used to alter heart rate (especially from atrial fibrillation), to prevent peripheral and cerebral vasospasm, and to reduce chest pain caused by angina pectoris. N-type, L-type, and T-type voltage-dependent calcium channels are present in the zona glomerulosa of the human adrenal gland, and CCBs can directly influence the biosynthesis of aldosterone in adrenocortical cells, with consequent impact on the clinical treatment of hypertension with these agents. CCBs have been shown to be slightly more effective than beta blockers at lowering cardiovascular mortality, but they are associated with more side effects. Potential major risks however were mainly found to be associated with short-acting CCBs. Classes Dihydropyridine Dihydropyridine (DHP) calcium channel blockers are derived from the molecule dihydropyridine and often used to reduce systemic vascular resistance and arterial pressure. Sometimes when they are used to treat angina, the vasodilation and hypotension can lead to reflex tachycardia, which can be detrimental for patients with ischemic symptoms because of the resulting increase in myocardial oxygen demand. Dihydropyridine calcium channel blockers can worsen proteinuria in patients with nephropathy. This CCB class is easily identified by the suffix "-dipine". Amlodipine (Norvasc) Aranidipine (Sapresta) Azelnidipine (Calblock) Barnidipine (HypoCa) Benidipine (Coniel) Cilnidipine (Atelec, Cinalong, Siscard) Not available in US Clevidipine (Cleviprex) Efonidipine (Landel) Felodipine (Plendil) Isradipine (DynaCirc, Prescal) Lacidipine (Motens, Lacipil) Lercanidipine (Zanidip) Manidipine (Calslot, Madipine) Nicardipine (Cardene, Carden SR) Nifedipine (Procardia, Adalat) Nilvadipine (Nivadil) Nimodipine (Nimotop) This substance can pass the blood-brain barrier and is used to prevent cerebral vasospasm. Nisoldipine (Baymycard, Sular, Syscor) Nitrendipine (Cardif, Nitrepin, Baylotensin) Pranidipine (Acalas) Non-dihydropyridine Phenylalkylamine Phenylalkylamine calcium channel blockers are relatively selective for myocardium, reduce myocardial oxygen demand and reverse coronary vasospasm, and are often used to treat angina. They have minimal vasodilatory effects compared with dihydropyridines and therefore cause less reflex tachycardia, making it appealing for treatment of angina, where tachycardia can be the most significant contributor to the heart's need for oxygen. Therefore, as vasodilation is minimal with the phenylalkylamines, the major mechanism of action is causing