Efonidipine is a mixture of R(-) and S(+) isomers that exerts long acting blocking actions on both T-type and L-type calcium channels. It has no blocking effects on N-, P/Q- and R-type Ca(2+) channels. While the S(+) isomer is an active blocker of both the T-type and L-type calcium channels, the action of which is similar to the racemic mixture, its R(-) isomer selectively blocks the T-type channel only. In the prevention of cardiovascular disease efonidipine inhibits in a dose dependent manner the Ang II- and K+-induced aldosterone secretion. It suppresses Ang-II and K+-induced mRNA expression of 11-beta-hydroxylase and aldosterone synthase and induces the production of DHEA sulfate, which has anti-atherosclerotic actions.