Vascular calcium channels and high blood pressure: Pathophysiology and therapeutic implications

Long-lasting Ca2+ (CaL) channels of the Cav1.2 gene family are heteromultimeric structures that are minimally composed of a pore-forming α1C subunit and regulatory β and α2δ subunits in vascular smooth muscle cells. The CaL channels are the primary pathways for voltage-gated Ca2+ influx that trigger excitation–contraction coupling in small resistance vessels. Notably, vascular smooth muscle cells of hypertensive rats show an increased expression of CaL channel α1C subunits, which is associated with elevated Ca2+ influx and the development of abnormal arterial tone. Indeed, blood pressure per se appears to promote CaL channel expression in small arteries, and even short-term rises in pressure may alter channel expression. Membrane depolarization has been shown to be one stimulus associated with elevated blood pressure that promotes CaL channel expression at the plasma membrane. Future studies to define the molecular processes that regulate CaL channel expression in vascular smooth muscle cells will provide a rational basis for designing antihypertensive therapies to normalize CaL channel expression and the development of anomalous vascular tone in hypertensive pathologies.