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A dose-response trial of once-daily diltiazem

J V Felicetta1, H M Serfer, N R Cutler

  • 1Carl T. Hayden VA Medical Center, Medical Service, Phoenix, AZ 85012.

American Heart Journal
|April 1, 1992
PubMed

Insights

This study found that once daily diltiazem hydrochloride extended-release capsules (diltiazem CD) effectively lower blood pressure in patients with essential hypertension. Doses between 180-540 mg showed a good trough-to-peak ratio, indicating sustained efficacy.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Essential hypertension is a widespread condition requiring effective treatment.
  • Diltiazem hydrochloride extended-release (diltiazem CD) is a calcium channel blocker used for hypertension.
  • Determining optimal dosage for sustained blood pressure control is crucial.

Purpose of the Study:

  • To establish the safe and effective dosage range of once-daily diltiazem CD for essential hypertension.
  • To evaluate the dose-response relationship of diltiazem CD on blood pressure and heart rate.

Main Methods:

  • A randomized, placebo-controlled trial involving patients with essential hypertension (supine diastolic blood pressure 95-110 mm Hg).
  • Patients received placebo or diltiazem CD at doses of 90, 180, 360, or 540 mg once daily.
  • Blood pressure and heart rate were measured at trough (24 hours) and peak effect (10 hours) post-dose.

Main Results:

  • Diltiazem CD significantly reduced supine diastolic and systolic blood pressure.
  • A linear dose-response relationship was observed for blood pressure and heart rate changes.
  • Trough-to-peak ratios exceeded 0.50 for doses of 180 mg and higher, indicating sustained action.
  • Adverse effects, including headache, bradycardia, and edema, were dose-related.

Conclusions:

  • Once-daily diltiazem CD is a safe and effective agent for treating essential hypertension.
  • Dosages of 180 mg, 360 mg, and 540 mg provide sustained 24-hour blood pressure control.
  • Dose-related adverse effects warrant consideration during treatment initiation.

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