Diltiazem-induced left ventricular mass regression in hypertensive patients
Related Experiment Videos
Insights
Timed-release diltiazem effectively lowers blood pressure and significantly reduces left ventricular mass compared to propranolol. This hypertension treatment offers superior cardiac benefits.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Hypertension management requires effective antihypertensive agents.
- Left ventricular mass is a key indicator of cardiovascular risk.
Purpose of the Study:
- To compare the antihypertensive efficacy and cardiac effects of timed-release diltiazem versus propranolol.
- To evaluate the impact of these drugs on left ventricular mass and vascular resistance.
Main Methods:
- A randomized, double-blind study involving 40 patients with mild to moderate hypertension.
- Echocardiograms were performed at baseline and after 6 months to assess left ventricular mass, end-systolic stress, total peripheral resistance, and cross-sectional area index.
- Patients received either timed-release diltiazem or propranolol.
Main Results:
- Both diltiazem and propranolol lowered blood pressure effectively.
- Diltiazem significantly reduced left ventricular mass and cross-sectional area index.
- Propranolol did not significantly alter left ventricular mass or cross-sectional area index.
- Diltiazem demonstrated a significantly greater decrease in left ventricular mass and cross-sectional index compared to propranolol.
Conclusions:
- Timed-release diltiazem is safe and equally efficacious as propranolol in controlling blood pressure.
- Diltiazem offers significant advantages over propranolol in reducing indices of cardiac hypertrophy.
Abstract:
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.