Responses to intravenous and oral diltiazem in elderly and younger patients with systemic hypertension |
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| Authors: | J B Schwartz D R Abernethy |
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| Affiliation: | 1. Department of Otorhinolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, PR China;2. Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, PR China;3. Key Laboratory of Otorhinolaryngology, Guangzhou, Guangdong, PR China;4. Department of Medical Statistics, Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, PR China;1. New York Structural Biology Center, 89 Convent Avenue, New York, NY 10027, USA;2. Department of Biochemistry and Molecular Biophysics, Columbia University, New York, NY 10032, USA;1. Central Clinical Laboratory, Matsushita Memorial Hospital, Osaka, Japan;2. Department of Cardiology, Matsushita Memorial Hospital, Osaka, Japan;3. Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine, Kyoto, Japan;1. Department of Health and Kinesiology, Applied Exercise Science Laboratory, Texas A&M University, College Station, Texas;7. Department of Athletics, Texas A&M University, College Station, Texas;2. Department of Cardiology, SSM Heart Institute/Clayton, SSM Health, St. Louis, Missouri;3. Department of Cardiology, Baylor Scott and White Clinic, Temple, Texas;4. Department of Cardiology, Baylor Scott and White Hospital, College Station, Texas;5. Department of Kinesiology, Texas Christian University, Fort Worth, Texas;6. Department of Orthopedics and Sports Medicine, Methodist Research Institute, Houston, Texas |
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| Abstract: | Diltiazem concentrations and blood pressure, heart rate, PR interval and forearm vascular resistance responses to intravenous (25 and 50 mg) and oral (120 mg) diltiazem were compared in 13 elderly persons (mean age 68 +/- 4 years) and 10 young persons (mean 30 +/- 5 years) with essential hypertension. Diltiazem elimination was slower in the elderly. After a dose of 25 mg, clearance was 13 +/- 4 ml/min/kg in the elderly and 23 +/- 7 in the young (p less than 0.05); after 50 mg, 16 +/- 6 and 21 +/- 12 ml/min/kg (p less than 0.05); and after oral administration, 22 +/- 9 and 35 +/- 14 ml/kg/min (p less than 0.02). No age-related differences in volume of distribution (by model or area methods) were seen. Elimination half-lives were 4.5 +/- 2.2 hours in the elderly and 3.8 +/- 0.7 hour in the young persons (p less than 0.01); 4.5 +/- 1.6 and 3.3 +/- 0.7 hours (p = 0.10); and 4.7 +/- 1.5 and 3.3 +/- 1.8 hours (p = 0.08) after 50, 25 and 120 mg. Maximal decreases in mean blood pressure were from 113 +/- 14 to 91 +/- 12 mm Hg (19%) in the elderly patients and from 108 +/- 8 to 99 +/- 9 mm Hg in the younger patients (8%) after 50 mg; from 106 +/- 13 to 93 +/- 14 mm Hg and from 109 +/- 11 to 99 +/- 13 mm Hg, respectively, after 25 mg; and from 113 +/- 10 to 97 +/- 10 mm Hg and from 109 +/- 11 to 97 +/- 8 after 120 mg orally.(ABSTRACT TRUNCATED AT 250 WORDS) |
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