Calcium channel blockers for the treatment of primary pulmonary hypertension

It has now been established that the natural history of patients with primary pulmonary hypertension can be dramatically improved using medical therapies that have been developed over the past decade. Amongst these are the calcium channel blockers. When used in maximal physiological effective doses, they are able to cause a reduction in pulmonary artery pressure and pulmonary vascular resistance, which leads to improved exercise tolerance and survival. The response to calcium blockers, however, is quite variable from patient to patient. Some patients can have adverse responses to these drugs which can have catastrophic results. The administration of calcium blockers to patients with primary pulmonary hypertension is quite complex and should be limited to institutions that have experience in this area.