Second Generation of Calcium Antagonists

"Another damned, thick, square book! Always scribble, scribble, scribble! Eh! Mr. Gibbon?" From the Literary Memoirs of Willi­ am, DUKE OF GLOUCESTER, 1743-1805 The foreword of any book is probably the most difficult to write -not only because it stands at the beginning of an exercise in writing and logic but because it is in this chapter that areader can expect to find a clear and unambiguous explanation of the author's reason for writing the book and why some subject matter has been included and other subject matter excluded. Potential readers ofthis book may not have an inclination to question why some subject matter has been excluded but instead may wonder why another book on calcium antagonists has been published. However, it is arguable with some force that there have been at least three recent developments in the field of calcium antagonism which provide more than adequate support for the view that another book on this topic is warranted. These developments include: (i) an improved understanding of the chemical structure, mode of action and architecture of the voltage-activated, calcium antagonist-sensitive calcium channels and their associated calcium-antagonist specific binding sites; (ii) a more accurate appreciation ofhow and when the calcium antagonists should be used in the management of a variety of clinical dis orders including cerebral ischaemia atherosclerosis, "mild" ischaemic heart disease, ventricular hyper­ trophy, impaired ventricular relaxation and hypertension (to name but a few), and (iii) the emergence of a second generation of calcium antagonists.