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Renal effects of prolonged antihypertensive treatment with diltiazem
G Tramonti1, C Donadio, L Silvestri
1Unità di Nefrologia, Clinica Medica 2, Università di Pisa, Italy.
Insights
Diltiazem effectively lowers blood pressure in hypertensive patients without significantly impacting renal function. However, periodic monitoring of plasma glucose and potassium levels is recommended during diltiazem treatment.
Area of Science:
- Cardiology
- Nephrology
Background:
- Hypertension management requires effective antihypertensive agents.
- Assessing the impact of antihypertensives on renal function is crucial.
Purpose of the Study:
- To evaluate the effects of diltiazem on blood pressure, renal function, and hemodynamics.
- To assess changes in plasma parameters during diltiazem therapy.
Main Methods:
- 14 adult patients with mild to moderate hypertension participated.
- A six-week trial involving placebo followed by oral diltiazem (120 mg b.i.d.).
- Measurements included blood pressure, heart rate, renal function tests, and plasma biochemistry.
Main Results:
- Diltiazem significantly reduced systolic and diastolic blood pressure in both supine and standing positions.
- Heart rate decreased, while plasma urea, creatinine, uric acid, GFR, and ERPF remained stable.
- Plasma glucose levels increased, and plasma potassium levels decreased significantly.
Conclusions:
- Diltiazem is an effective antihypertensive agent with no significant adverse effects on renal function.
- Periodic monitoring of plasma glucose and potassium is advised during diltiazem treatment.
Abstract:
The effects of diltiazem (DTZ) treatment on blood pressure, renal function and renal hemodynamics over a six week period of therapy were evaluated in 14 adult patients with mild to moderate hypertension. Their creatinine clearances were 64 to 153 ml/min. After a week of treatment with placebo, DTZ was administered orally at a daily dose of 120 mg b.i.d. Blood pressure decreased from a mean value of 152/99 mm Hg (+/-13/6 SD) up to 144/91 (+/-17/8, P < 0.005) in the supine position and from 149/107 (+/-14/9) to 141/96 (+/-16/9, P < 0.005) in standing position. Heart rate decreased from 74 (+/-9) to 69 (+/-8). Plasma urea, creatinine, uric acid and their clearances as well as GFR and ERPF remained stable throughout the trial. Plasma glucose increased from 81 (+/-15) mg/dl to 98 (+/-30, P < 0.05) and plasma potassium decreased from 4.0 mEq/liter to 3.7 (+/-0.3, P < 0.005). Plasma cholesterol and triglycerides were unmodified. DTZ is an effective antihypertensive agent which does not significantly affect renal function. The effects on plasma glucose and potassium require periodical check-ups of these parameters.