The determinants of response to diltiazem in hypertension.
We examined factors (blood pressure, plasma renin activity, and age) influencing the antihypertensive response in essential hypertensive patients given 240 mg/day of slow-release diltiazem in an unblinded study after a placebo run-in period. Subjects provided a range of diastolic blood pressures (90 to 115 mm Hg), of age (31 to 70 years), and of plasma renin activity (0.1 to 2.7 ng angiotensin I/ml/hr) on a 70 to 150 mEq sodium diet. Blood pressure, plasma renin activity, and plasma diltiazem concentrations were measured after the first (n = 21) and final dose (n = 19) of 120 mg diltiazem, twice daily for 4 weeks. Multiple linear stepwise regression of change in blood pressure versus age, plasma renin activity, and baseline blood pressure showed baseline blood pressure was the only predictor of response (p = 0.0002). For each increase of 10 mm Hg in baseline pressure there was a 7 mm Hg greater decrease in diastolic blood pressure. We conclude that patient age and plasma renin activity are not clinically significant predictors of antihypertensive response to diltiazem in hypertension.
Shepherd
A M
AM
Department of Pharmacology, University of Texas Health Science Center, San Antonio 78284-7764.
LeForce
C
C
Park
G D
GD
Hoop
R S
RS
Weir
S
S
D000328:Adult; D000367:Age Factors; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D003692:Delayed-Action Preparations; D004110:Diltiazem / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D006207:Half-Life; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D012044:Regression Analysis; D012083:Renin / Q000097:blood; D012964:Sodium / Q000652:urine; D014664:Vasodilation / Q000187:drug effects
D003692:Delayed-Action Preparations; D012964:Sodium; D012083:Renin; D004110:Diltiazem