COMPARISON OF AMLODIPINE AND LONG-ACTING DILTIAZEM IN THE TREATMENT OF MILD OR MODERATE HYPERTENSION

The comparative effects of the once a day calcium channel antagonists amlodipine and long-acting diltiazem were assessed in a parallel desig n, investigator-blinded, multicenter trial in 123 patients with diasto lic blood pressures ranging from 95 to 114 mm Hg before treatment. Pat ients were randomized to one of the two drugs and titrated at 2-week i ntervals to 5 or 10 mg of amlodipine or 180, 240, or 360 mg of long-ac ting diltiazem during a 10-week treatment period. Both drugs significa ntly reduced resting, sitting, standing, and 24-h ambulatory systolic and diastolic pressures. amlodipine caused significantly greater reduc tions in sitting and standing systolic pressures, standing diastolic p ressures, and 24-h ambulatory systolic and diastolic pressures versus diltiazem. Sitting systolic pressures were reduced from 151.9 +/- 2.0 (SE) at baseline to 137.9 +/- 1.8 mm Hg with amlodipine treatment and from 149.0 +/- 2.1 to 145.1 +/- 2.5 mm Hg with diltiazem. Sitting dias tolic pressures were reduced from 100.2 +/- 0.6 to 87.8 +/- 1.0 mm Hg with amlodipine and from 101.1 +/- 1.0 to 91.9 +/- 1.1 mm Hg with dilt iazem. Reductions in standing systolic pressures after treatment were -12.1 +/- 1.5 mm Hg amlodipine v -4.6 +/- 1.5 mm Hg diltiazem (P < .01 ), and reductions in standing diastolic pressures were -11.8 +/- 0.9 m m Hg amlodipine upsilon -8.6 +/- 0.9 mm Hg diltiazem (P < .02). Heart rates did not change significantly with either drug during the study. Two subjects in each group dropped out because of adverse experiences. although both agents were well tolerated and reduced blood pressures consistently over the 10-week test period, amlodipine was more effecti ve than diltiazem in reducing systolic and diastolic blood pressures t o the target pressures of < 140 mm Hg systolic and < 90 mm Hg diastoli c over a range of doses widely used in clinical practice. (C) 1997 Ame rican Journal of Hypertension, Ltd.