Diltiazem as monotherapy in treatment of mild to moderate essential hypertension.

The effectiveness and safety of diltiazem monotherapy was evaluated in 29 patients with mild to moderate essential hypertension (diastolic pressure between 95 and 115 mmHg). There were 16 men and 13 women, ages ranged from 29 to 58 years (mean 43). After a 2-week placebo period, each patient was given a 60 mg diltiazem tablet three times a day for 8 weeks. Blood pressure and heart rate were determined at weekly clinic visits. Three patients were withdrawn from the study because of a skin rash, palpitation and a frequent loose stool, respectively. In the remaining 26 patients, the mean systolic and diastolic blood pressures were reduced significantly in 2 weeks of therapy and thereafter. At the end of the 8-week treatment the mean supine blood pressure decreased from 158/103 at baseline to 139/94 mmHg, the mean sitting blood pressure from 156/104 to 136/93 mmHg, and the mean standing blood pressure from 151/104 to 134/96 mmHg. The heart rate did not change significantly before or during diltiazem treatment. In 16 (61.5%) of the 26 patients, diltiazem consistently reduced the diastolic blood pressure more than 5 mmHg throughout 2 to 8 weeks of treatment. The left ventricular mass and ejection fraction assessed with M-mode echocardiograms were normal before diltiazem treatment, and remained unchanged 8 weeks after the treatment. By using treadmill exercise tests, there was a significant increase in exercise duration and a significant reduction in the peak heart rate at 8 weeks after the treatment. The peak systolic blood pressure did not change significantly.(ABSTRACT TRUNCATED AT 250 WORDS)