Abstract

The effects of two calcium channel blockers, Diltiazem-SR(D) and Amlodipine (A) were evaluated in 24 essential hypertensives (age 54±8 yrs, 20 M, 4F) treated for 6 months in a randomized, parallel group study (n=12 per group) with either D (200 or 300 mg qd) or A (5 or 10 mg qd). Office systolic (SBP) and diastolic (DBP) blood pressure, SBP at handgrip (HG), at peak exercise tolerance test (ETT) and 24h ambulatory BP monitoring (ABPM), plasma norepinephrine (NE) levels and diastolic dysfunction by echo (E/A ratio) were recorded at baseline and endpoint (Results presented as means ± SD*p<0.01, #p<0.05 vs baseline).

SBP decreased by 15±9%* with A vs 14±9%* with D and DBP 18±7%* vs 16 ± 8%*, respectively. At HG max SBP decreased by 13±7%* with both drugs and max DPB by 12.7%* for A and 15±13%* for D, respectively. In ETT both drugs decreased max SBP* and double product# and increased the duration of exercise by15% with A# and 30% with D#. With ABPM SBP and DBP decreased significantly with both drugs.* NE levels increased by 34±46% with A and decreased 8±40% with D (both NS). The E/A ratio decreased by 7.4% with A and increased by 15% with D (both NS). No one dropped out due to side effects.

In conclusion both drugs were equally effective in reducing resting and stimulated BP, and improving functional capacity (duration of ETT); neither produced significant change in echo parameters or catecholamine profile, despite tendency to directionally opposite changes.

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