Twice daily dosing of diltiazem in the treatment of mild to moderate essential hypertension

Traditionally, the treatment of essential hypertension has been in accordance with the stepped care appraoch as outlined by the Hypertension Detection and follow-up Program and supported by the the recommendations of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure. While diuretics and beta-blockers have been utilized as step one agents, recent questions have been raised regarding the safety of these agents in mild hypertension. Due to potential deleterious effects associated with the use of diuretics and beta-blockers as step one antihypertensives, further investigation of alternative drugs for the treatment of mild to moderate essential hypertension is warranted. An ideal antihypertensive agent should be low in cost, have relatively few side effects, be given in a simplified dosage regimen (once or twice daily) and be free of adverse effects on serum lipids, glucose or electrolytes. A surge of interest in the use of calcium channel blockers in the treatment og hypertension is evident by the number of recent reports and symposia in the literature on this topic. Reviews of several studies with the calcium channel blockers nifedipine and verapamil have demonstrated their efficacy in the treatment of essential hypertension. Only a few trials have been conducted on the efficacy of diltiazem. The purpose of this investigation was to evaluate the clinical efficacy and side effect profile of three dosages of diltiazem in a twice daily dosing regimen in the treatment of mild to moderate hypertension and to determine if a correlation between serum concentration and blood pressure effect exists.