New anti-ischaemic drugs: cytoprotective action with no primary haemodynamic effects

Currently therapy for ischaemic heart disease is based on drugs such as β-adrenoceptor antagonists, Ca²⁺ antagonists and nitrates, which have pronounced haemodynamic effects. However, these drugs can have adverse reactions including systemic haemodynamic effects, leading to low blood pressure and peripheral oedema in some patients. Recent observations that certain types of Ca²⁺ antagonist prevent the Ca²⁺ overload that occurs after ischaemia have led to the design of new anti-ischaemic drugs that are cytoprotective, but have no (or few) haemodynamic effects. In this article, Pieter van Zwieten and colleagues assess the therapeutic potential of these drugs.