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Effect of long-term diltiazem treatment on central haemodynamics and exercise endurance in essential hypertension

P Lund-Johansen1, P Omvik

  • 1Medical Department, University of Bergen, School of Medicine, Norway.

European Heart Journal
|June 1, 1990
PubMed

Insights

Long-term diltiazem treatment effectively lowers blood pressure in hypertensive men by reducing peripheral resistance. This essential hypertension therapy also improves exercise endurance without compromising cardiac output.

Area of Science:

  • Cardiology
  • Pharmacology
  • Hypertension Research

Background:

  • Essential hypertension affects numerous individuals, necessitating effective long-term management strategies.
  • Diltiazem is a calcium channel blocker commonly prescribed for hypertension.
  • The impact of sustained diltiazem use on haemodynamics and exercise capacity requires thorough investigation.

Purpose of the Study:

  • To evaluate the long-term effects of diltiazem on blood pressure, central haemodynamics, and exercise endurance in men with essential hypertension.
  • To assess changes in heart rate, cardiac output, and total peripheral resistance after one year of diltiazem treatment.
  • To determine if diltiazem affects cardiac pump function and blood flow during exercise.

Main Methods:

  • A study involving 16 men with essential hypertension, aged 52 years on average.
  • Continuous monitoring of intra-arterial pressure and heart rate (HR).
  • Cardiac output (CO) measurement at rest and during graded bicycle exercise, with repeated measurements after sustained exercise.

Main Results:

  • One year of diltiazem treatment (mean dose 278 mg/day) significantly reduced intra-arterial pressure (14% reduction at rest) due to decreased total peripheral resistance.
  • Heart rate (HR) decreased at rest (7%) and during exercise (10%), while stroke volume tended to increase and cardiac output (CO) remained unchanged.
  • Exercise time at a constant workload increased by 25%, indicating improved exercise endurance. Cardiac function was maintained during exercise.

Conclusions:

  • Long-term diltiazem treatment is effective in reducing blood pressure in essential hypertension by lowering total peripheral resistance.
  • Diltiazem treatment does not impair cardiac pump function or reduce blood flow during exercise.
  • The study supports the use of diltiazem for long-term management of hypertension, with benefits for exercise capacity.

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