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Treatment of arterial hypertension in the elderly with diltiazem vs ramipril
1Department of Geriatrics and Gerontology, University of Catania.
Insights
Sustained-release diltiazem effectively treated elderly patients with hypertension, showing similar blood pressure results to ramipril with better tolerability. This calcium antagonist is a well-tolerated option for managing hypertension in older adults.
Area of Science:
- Cardiology
- Geriatrics
- Pharmacology
Background:
- Arterial hypertension affects approximately 40% of the elderly population, necessitating effective antihypertensive treatments.
- Calcium antagonists, like diltiazem, are utilized for hypertension due to their vasodilatory properties.
- Essential hypertension management in the elderly requires evaluating drug efficacy and tolerability.
Purpose of the Study:
- To compare the efficacy and tolerability of diltiazem versus ramipril in elderly patients with essential arterial hypertension.
- To assess the impact of sustained-release diltiazem on blood pressure and heart rate in geriatric patients.
- To evaluate the safety profile of diltiazem compared to ramipril in this demographic.
Main Methods:
- A controlled, single-blind study involving 50 elderly patients with essential arterial hypertension.
- Random assignment to two groups: Group A (25 patients) received 300 mg sustained-release diltiazem daily; Group B (25 patients) received 5 mg ramipril daily.
- A 6-month treatment period evaluating systolic and diastolic blood pressure and heart rate.
Main Results:
- Both diltiazem and ramipril led to normalization of systolic and diastolic blood pressure in most patients.
- Diltiazem showed a more persistent reduction in heart rate, consistent with its mechanism of action.
- Diltiazem treatment was well-tolerated, with no patients discontinuing therapy, unlike one patient on ramipril who developed a persistent cough.
Conclusions:
- Sustained-release diltiazem at 300 mg/day is effective and well-tolerated for mild to moderate essential arterial hypertension in the elderly.
- Both diltiazem and ramipril demonstrated comparable efficacy in reducing arterial blood pressure.
- Diltiazem presents a favorable tolerability profile for antihypertensive therapy in aged individuals.
Background:
Around 40% of the elderly population suffer from arterial hypertension. An effective antihypertensive treatment is therefore required. Calcium antagonists are used to treat hypertension because, owing to their mechanism of action, they can provoke systemic, as well as coronary vasodilatation. In this study the authors aimed to evaluate the activity and tolerability of diltiazem compared to ramipril in a group of elderly patients suffering from essential arterial hypertension.
Methods:
A controlled single-blind study was performed in which patients were randomly assigned to one of two groups, A and B, consisting of 25 patients each, treated respectively with 300 mg sustained-release diltiazem or 5 mg ramipril in a single daily dose. The study lasted 6 months and evaluated systolic and diastolic pressure and heart rate.
Results:
The evolution was positive in all patients in Group A and most patients in Group B, with the normalisation of both systolic and diastolic values. Heart rate showed a more persistent fall in Group A, but this was expected owing to the mechanism of action of diltiazem. No patient in Group A had to suspend treatment, whereas one patient in Group B had to interrupt therapy following the onset of a persistent cough.
Conclusions:
Both treatments resulted in similar changes in systolic and diastolic arterial blood pressure. In the light of these results, it can be affirmed that, at an oral dose of 300 mg/day, sustained-release diltiazem was found to be effective and well tolerated in the treatment of mild to moderate essential arterial hypertension in the aged.
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