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European Heart Journal 1990 11(6):543-551;
Copyright © 1990 by the European Society of Cardiology.
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© 1990 The European Society of Cardiology

Effect of long-term diltiazem treatment on central haemodynamics and exercise endurance in essential hypertension

P. LUND-JOHANSEN and P. OMVIK

Section of Cardiology, Medical Department, University of Bergen, School of Medicine Bergen, Norway

Received 14 August 1989; revised 14 November 1989; .

Address for correspondence to: Per Lund-Johansen MD, Section of Cardiology, Medical Department, 5021 haukeland Hospital, Bergen, Norway.

Abstract

The effects of long-term treatment with diltiazem on blood pressure, central haemodynamics and exercise endurance were studied in 16 men (mean age 52 years) with essential hypertension. Intra-arterialpressure and heart rate (HR) were monitored continuously. Cardiac output (CO) was measured by Cardiogreen at rest (supine and sitting) and during 50 W, 100 Wand 150 W bicycle exercise. Haemodynamic measurements were repeated after continous bicycling at 150 Wfor 20 min or until exhaustion. After 1 year on diltiazem (mean daily dose 278 mg) intra-arterial pressure was reduced (P <0001) in all situations (at rest sitting from 183/ 108 mmHg to 157/92 mmHg (14%)) due to reduction in total peripheral resistance. HR was reduced at rest (7%) and during exercise (10%). Stroke volume tended to increase while CO was unchanged. Exercise time at constant workload increased by 25%. After apeak level, intra-arterial pressure fell by 3% to 5% (P<0.05) due to a decrease in total peripheral resistance both before and during diltiazem treatment. Stroke volume and CO remained unchanged during endurance exercise while HR showed a small increase. Thus, there was no reduction in the overall cardiac pump function after long-term diltiazem treatment, and blood flow during exercise was maintained.

Key Words: Calcium antagonist • endurance • essential hypertension • exercise • extracellular fluid volume • diltiazem • haemodynamics • plasma volume


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