Immediate and short-term hemodynamic effects of diltiazem in patients with hypertension

Amodeo, Celso, Kobrin, Isaac, Ventura, Hector O., Messerli, Franz H. and Frohlich, Edward D. (1986) Immediate and short-term hemodynamic effects of diltiazem in patients with hypertension. Circulation, 73 1: 108-113.

Author Amodeo, Celso
Kobrin, Isaac
Ventura, Hector O.
Messerli, Franz H.
Frohlich, Edward D.
Title Immediate and short-term hemodynamic effects of diltiazem in patients with hypertension
Journal name Circulation   Check publisher's open access policy
ISSN 0009-7322
Publication date 1986-01
Sub-type Article (original research)
Volume 73
Issue 1
Start page 108
End page 113
Total pages 6
Place of publication Baltimore, MD United States
Publisher Lippincott Williams and Wilkins
Language eng
Formatted abstract
The immediate effects of intravenous diltiazem effects and short-term (4 weeks) of the oral drug on systemic and regional hemodynamics, cardiac structure, and humoral responses were evaluated by previously reported methods in nine patients with mild-to-moderate essential hypertension and in one patient with primary aldosteronism. Diltiazem was first administered in three intravenous doses of 0.06, 0.06, and 0.12 mg/kg, respectively; patients were then treated for 4 weeks with daily doses ranging from 240 to 360 mg (average 300 mg). Intravenous diltiazem immediately reduced mean arterial pressure (from 115 ± 3 to 96 ± 3 mm Hg; p<.01) through a fall in total peripheral resistance index (from 37 ± 3 to 23 ± 2 U/m2; p<.01) that was associated with an increase in heart rate (from 66 ± 2 to 77 ± 3 beats/min; p<.01) and cardiac index (from 3.3 ± 0.3 to 4.3 ± 0.4 liters/min/m2; p<.01). These changes were not associated with changes in plasma levels of catecholamines or aldosterone or in plasma renin activity. After 4 weeks the significant decrease in mean arterial pressure persisted (104 ± 3 mm Hg; p<.01) and there were still no changes in the humoral substances or plasma volume. Renal blood flow index increased (from 368 ± 52 to 462 ± 57 ml/min/m2; p<.01) and renal vascular resistance index decreased (from 0.37 ± 0.06 to 0.26 ± 0.04 U/m2; p<.01), while splanchnic hemodynamics did not change. Left ventricular mass significantly decreased (from 242 ± 16 to 217 ± 14 g; p<.01). Thus, the fall in arterial pressure produced by diltiazem was associated with improved renal hemodynamics and reduced left ventricular mass without expansion of intravascular volume or alterations in circulating humoral substances.
Keyword Aldosterone
Indocyanine Green
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Mon, 14 Mar 2011, 10:07:24 EST