Diltiazem as monotherapy in treatment of mild to moderate essential hypertension.

M S Chern, W J Cherng, J S Hung, J J Wu
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Abstract

The effectiveness and safety of diltiazem monotherapy was evaluated in 29 patients with mild to moderate essential hypertension (diastolic pressure between 95 and 115 mmHg). There were 16 men and 13 women, ages ranged from 29 to 58 years (mean 43). After a 2-week placebo period, each patient was given a 60 mg diltiazem tablet three times a day for 8 weeks. Blood pressure and heart rate were determined at weekly clinic visits. Three patients were withdrawn from the study because of a skin rash, palpitation and a frequent loose stool, respectively. In the remaining 26 patients, the mean systolic and diastolic blood pressures were reduced significantly in 2 weeks of therapy and thereafter. At the end of the 8-week treatment the mean supine blood pressure decreased from 158/103 at baseline to 139/94 mmHg, the mean sitting blood pressure from 156/104 to 136/93 mmHg, and the mean standing blood pressure from 151/104 to 134/96 mmHg. The heart rate did not change significantly before or during diltiazem treatment. In 16 (61.5%) of the 26 patients, diltiazem consistently reduced the diastolic blood pressure more than 5 mmHg throughout 2 to 8 weeks of treatment. The left ventricular mass and ejection fraction assessed with M-mode echocardiograms were normal before diltiazem treatment, and remained unchanged 8 weeks after the treatment. By using treadmill exercise tests, there was a significant increase in exercise duration and a significant reduction in the peak heart rate at 8 weeks after the treatment. The peak systolic blood pressure did not change significantly.(ABSTRACT TRUNCATED AT 250 WORDS)

地尔硫卓单药治疗轻中度原发性高血压。
对29例轻中度原发性高血压(舒张压在95 ~ 115 mmHg)患者应用地尔硫卓单药治疗的有效性和安全性进行了评价。男性16例,女性13例,年龄29 ~ 58岁,平均43岁。在2周的安慰剂期后,每位患者服用60毫克的地尔硫卓片,每天3次,持续8周。在每周一次的门诊检查中测定血压和心率。三名患者分别因皮疹、心悸和频繁大便而退出研究。在其余26例患者中,平均收缩压和舒张压在治疗2周后显著降低。8周治疗结束时,平均仰卧位血压从基线时的158/103降至139/94 mmHg,平均坐位血压从156/104降至136/93 mmHg,平均站立血压从151/104降至134/96 mmHg。在地尔硫卓治疗前和治疗期间,心率无明显变化。在26例患者中,16例(61.5%)在2 - 8周的治疗中,地尔硫卓持续降低舒张压超过5 mmHg。使用m型超声心动图评估左心室质量和射血分数在地尔硫卓治疗前正常,治疗后8周保持不变。通过使用跑步机运动测试,在治疗后8周,运动时间显着增加,心率峰值显着降低。收缩压峰值无明显变化。(摘要删节250字)
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