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[Demographic characteristics and response to antihypertensive treatment. Study using fixed doses of diltiazem]
Insights
Calcium channel blockers like diltiazem effectively lower blood pressure (BP). However, this study found that age did not significantly impact diltiazem
Area of Science:
- Cardiology
- Pharmacology
- Geriatrics
Context:
- Antihypertensive drug selection increasingly considers demographics.
- Calcium antagonists are theorized to be more effective in older adults.
- Stepped care guidelines now include four classes of antihypertensive drugs.
Purpose:
- To investigate the relationship between demographic factors and diltiazem response in hypertension management.
- To evaluate if age influences the efficacy of diltiazem monotherapy.
Summary:
- This study assessed diltiazem 120 mg b.i.d. monotherapy in 231 hypertensive patients (average age 59).
- Diltiazem significantly reduced systolic and diastolic blood pressure.
- Blood pressure reduction was correlated with baseline values but not significantly influenced by age, despite higher baseline BP in older patients.
Impact:
- Findings suggest age may not be a primary determinant for diltiazem efficacy in hypertension.
- Provides evidence for personalized antihypertensive treatment strategies.
- Highlights the importance of considering individual patient factors beyond age in drug selection.
Abstract:
Since the stepped care approach has been widened to four classes of antihypertensive drugs, demographic considerations enter into the choice of the first line drug. Calcium antagonists have been claimed to be more active in older patients because the average BP decrease after dose titration could be greater in this age group than in younger people. In this study, the response to a fixed dose of diltiazem has been related to different demographic factors. The selected patients have been treated with diltiazem 120 mg b.i.d. in monotherapy for at least 14 days irrespective of their response to a lower dose. There were 231 patients (115 M, 116 F). Their average age was 59 +/- 11 years (24 to 82) and their treatment duration was 44 +/- 27 days. Diltiazem lowered BP from 171 +/- 1/103 +/- 7 mmHg to 156 +/- 1/91 +/- 1 mmHg. The decline in both SBP and DBP with diltiazem was significantly related to their control values (r = 0.31 and 0.28 respectively, p less than 0.0001 for both). Although control SBP was related to age (r = 0.40, p less than 0.0001), its decrease with diltiazem was not. Neither control DBP nor its decrease with diltiazem were related to age. Although the average SBP was higher in patients over 60 years than in younger patients (176 +/- 2 mmHg, n = 124 vs 166 +/- 2 mmHg, n = 107, p less than 0.01), its decrease with diltiazem was not significantly greater (- 16 +/- 2 vs - 15 +/- 1 mmHg).(ABSTRACT TRUNCATED AT 250 WORDS)