Calcium channel blockers (CCBs) act by causing peripheral vasodilation but with less reflex tachycardia and fluid retention than other vasodilators. There are 2 types of CCBs - non-dihydropyridine agents and dyhydropyridine agents. Non-dihydropyridine CCBs (including verapamil and diltiazem) directly block the AV node and decrease heart rate and cardiac concentration, whereas the dyhydropyridine agents are primarily vasodilators that can cause a reflex tachycardia. The protective effect against stroke is well established. Nevertheless, they are rarely recommended for patients with heart failure (HF) because negative inotropic effects of CCBs may worsen HF and increase the risk of death[232-235]. Diabetic patients receiving CCBs may have higher rates of HF and MI. The most common AEs are headache, peripheral edema, bradycardia and constipation.
