Which antihypertensive agent is recommended to manage calcineurin inhibitor-induced hypertension?

Dihydropyridine calcium channel blockers (CCBs) are recommended to manage calcineurin inhibitor-induced hypertension primarily due to their effectiveness and favorable side-effect profile in this specific scenario. Calcineurin inhibitors, such as cyclosporine and tacrolimus, are commonly used in patients undergoing transplant therapy but can lead to hypertension through various mechanisms, including systemic vasoconstriction and increased arterial stiffness.

Dihydropyridine CCBs work by causing vascular smooth muscle relaxation, resulting in vasodilation and subsequently lowering blood pressure, which can effectively counteract the pressor effects of calcineurin inhibitors. This category of antihypertensive agents is particularly beneficial in patients who may experience adverse effects with other classes of antihypertensives, such as ACE inhibitors or beta-blockers.

In contrast, while other options like chlorthalidone, lisinopril, and beta-blockers can also manage hypertension, they may not be as first-line recommendations in this specific context. For instance, thiazide diuretics, although effective in hypertension management, can potentially exacerbate renal function when used in conjunction with calcineurin inhibitors. Lisinopril, an ACE inhibitor, is beneficial in many hypertensive scenarios,