Calcium antagonists are potent vasodilators. They improve arterial compliance by their action at the level of the large arteries. Several experimental and clinical studies have shown decreases of varying magnitudes in hypertension-induced cardiac hypertrophy after long term treatment. It appears that the mechanisms of this reduction in cardiac mass are complex. As arterial compliance is one of the determinants of left ventricular hypertrophy in hypertension, it may be considered that an improvement in cardiac mass can result not only from the blood pressure reduction but also from the increase in arterial compliance associated with calcium antagonist treatment in essential sustained hypertension.