ISSN:
1432-1041
Keywords:
hypotensive effect
;
diltiazem
;
plasma level
;
normotension
;
essential hypertension
;
plasma renin
;
arterial vasodilatation
Source:
Springer Online Journal Archives 1860-2000
Topics:
Chemistry and Pharmacology
,
Medicine
Notes:
Summary The hypotensive effect of acute and long-term, intravenous and oral administration of the calcium antagonist, diltiazem, was investigated in 8 normotensive volunteers and 55 patients with essential hypertension. Diltiazem i.v. infusion of 45 mg/h (0.5 mg/min, then 1.0 mg/min, each for 30 min rapidly decreased both blood pressure (BP) from 164±22/98±8 to 144±15/86±9 mmHg (mean±SD) and total peripheral resistance from 32.6±8.4 to 25.3±5.4 mmHg/l/min (p〈0.001), and increased stroke volume from 58.2±9.5 to 64.2±8.6 ml/beat (p〈0.05). It altered neither heart rate nor cardiac output in the hypertensives (n=10). Oral diltiazem 60 mg rapidly decreased BP from 155±10/103±6 to 142±12/90±8 mmHg after 3 hours (p〈0.01/p〈0.001) in hypertensives (n=8), but not in normotensives (n=8). Diltiazem 90 mg p.o. decreased BP from 157±15/102±9 to 129±13/83±8 mmHg (p〈0.01) in hypertensives (n=15), and reduced the heart rate from 71±8 to 65±8 beats/min (p〈0.01). The drug did not change plasma renin activity either in normotensives or hypertensives. The fall in diastolic BP was correlated with the plasma diltiazem concentration (r=0.910, n=6, p〈0.05). Long-term treatment with diltiazem 30mg t.d.s. decreased BP from 163±12/104±8 to 145±9/88±9 mmHg (p〈0.001, n=13), and 60mg t.d.s. decreased BP from 169±15/102±6 to 148±13/87±8 mmHg (p〈0.001, n=8), and significantly reduced the heart rate (p〈0.01) in hypertensives. Thus, the hypotensive action of diltiazem, which is due to arterial dilatation, is effective, either on intravenous or oral administration, during acute and long-term treatment of essential hypertension.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00542114
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