Which class is often used to treat hypertension by vasodilation with minimal cardiac effects?

• A. Non-dihydropyridine calcium channel blockers
• B. Dihydropyridine calcium channel blockers
• C. ACE inhibitors
• D. Beta-blockers

Answer: (B)

The main idea is using a drug that lowers blood pressure primarily by relaxing vascular smooth muscle with little direct effect on the heart. Dihydropyridine calcium channel blockers do this best: they preferentially block L-type calcium channels in arterial smooth muscle, causing arteriolar dilation, reduced peripheral resistance, and lower blood pressure, while having relatively minimal impact on myocardial contractility or conduction. Non-dihydropyridine calcium channel blockers affect the heart more strongly (they can slow the heart and reduce contractility), so they’re less suited to the goal of vasodilation with minimal cardiac effects. ACE inhibitors and beta-blockers don’t fit as cleanly for this specific description, since the former act via the renin-angiotensin system and can have varied cardiac effects, and the latter reduce heart rate and contractility rather than acting mainly as vascular dilators.