Diltiazem-induced left ventricular mass regression in hypertensive patients

The antihypertensive efficacy of timed-release diltiazem was compared with propranolol in a randomized, double-blind study of 40 patients with mild to moderate hypertension. Patients (diltiazem = 17; propranolol = 9) had echocardiograms at baseline and after 6 months of therapy to determine left ventricular mass, end-systolic stress, total peripheral resistance, and cross-sectional area index. Diltiazem lowered the blood pressure (152/98 to 134/83), as propranolol did (155/98 to 150/85). Diltiazem caused a significant reduction in left ventricular mass (215.1 +/- 56.3 to 175.7 +/- 54.7 g; p less than 0.0007) and in cross-sectional area index (5.7 +/- 1.0 to 4.8 +/- 1.1 cm2; p less than 0.002). Propranolol caused no change in mass (227.5 +/- 45.6 to 227.4 +/- 54.0) and no change in cross-sectional area index (5.3 +/- 0.8 to 5.5 +/- 1.2). Comparisons between diltiazem and propranolol showed a significantly greater decrease in mass with diltiazem (p less than 0.03) and cross-sectional index (p less than 0.015). Diltiazem proved to be safe and equally efficacious in blood pressure control and significantly better in reducing indices of mass hypertrophy than propranolol.