Diltiazem in the treatment of mild or moderate essential hypertension. Comparison with metoprolol in a crossover double-blind trial.

The antihypertensive efficacy and tolerability of a calcium antagonist drug, diltiazem (60 mg q.i.d. per os), was compared with that of metoprolol (100 mg b.i.d. pr os) in a crossover, double-blind randomized trial in 20 patients with mild or moderate essential hypertension. Blood pressure and heart rate were assessed at rest and during bicycle exercise before and after four-week periods of treatment. Both metoprolol and diltiazem reduced significantly systolic and diastolic blood pressure, while heart rate decreased only after metoprolol therapy. The reduction in blood pressure and the percentage of patients who responded favorably were similar with the two drugs. Furthermore, the overall levels of blood pressure during exercise were significantly reduced by both treatments, while only metoprolol was able to reduce the maximum increase in systolic blood pressure and heart rate induced by exercise. These results suggest that the use of diltiazem may be appropriate to the treatment of patients with mild or moderate essential hypertension.