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Comparison of the efficacy and safety of once-daily versus twice-daily formulations of diltiazem in the treatment of systemic hypertension

  • Hypertension
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Summary

The efficacy and safety of optimally titrated once-daily (CD) and twice-daily (SR) diltiazem were compared in 111 patients with mild to moderate systemic hypertension [seated diastolic blood pressure (DBP) ≥95 mmHg and ≤114 mmHg] in a multicenter, randomized, double-blind, placebo run-in, parallel-group trial. Following a 4 week washout and placebo-controlled run-in period, patients were randomized to receive diltiazem CD 180 mg and matching placebo (n=54), or diltiazem SR 90 mg bid (n=57). Total daily doses were titrated from 180 mg to 360 mg to achieve a goal of seated DBP <90 mmHg during a 6 week titration period. The patients continued to receive their optimal dose for a 6 week follow-up period. Ninety-six (96) patients (diltiazem CD: 47, diltiazem SR: 49) completed the study protocol, with 60% of the diltiazem CD and 55% of the diltiazem SR patients achieving the goal of seated DBP of <90 mmHg (p=0.685). Although significant decreases occurred in seated and standing measurements of diastolic and systolic BP and heart rate with treatment in both groups, there were no significant differences between treatment groups. Both medications were well tolerated, with a similar frequency of adverse effects [diltiazem CD: 24/54 (37%) patients; diltiazem SR: 24/57 (42.1%) patients] with the most frequently reported adverse effects being headache and edema.

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Authors and Affiliations

  1. University of Ottawa Heart Institute, 1053 Carling Avenue, K1Y 4E9, Ottawa, Ontario, Canada

    Terrence David Ruddy

  2. UBC Site, University Hospital, Vancouver, BC, Canada

    James M. Wright

  3. Notre-Dame Hospital, Montreal, Quebec, Canada

    Daniel Savard

  4. Saint John Regional Hospital, Saint John, New Brunswick, Canada

    S. Paul Handa

  5. Memorial University, St. John's, Newfoundland, Canada

    Arun Chockalingam

  6. Nordic Merrell Dow Research, Laval, Quebec, Canada

    André P. Boulet

Authors
  1. Terrence David Ruddy
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  2. James M. Wright
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  3. Daniel Savard
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  4. S. Paul Handa
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  5. Arun Chockalingam
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  6. André P. Boulet
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For The Canadian Multicenter Diltiazem-CD Hypertension Trial Group

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See appendix for list of participants.

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Ruddy, T.D., Wright, J.M., Savard, D. et al. Comparison of the efficacy and safety of once-daily versus twice-daily formulations of diltiazem in the treatment of systemic hypertension. Cardiovasc Drug Ther 9, 413–420 (1995). https://doi.org/10.1007/BF00879030

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  • DOI: https://doi.org/10.1007/BF00879030

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