The efficacy and tolerance to three doses of diltiazem in elderly patients with stable angina.

Twelve patients aged 71-82 years with chronic stable angina were treated with the calcium antagonist diltiazem in three successive doses, 180, 270 and 360 mg/day each over two weeks. Exercise tolerance increased and trinitrin consumption fell on the first dose but showed no further change on the higher doses. Heart rates at rest and on maximal treadmill exercise were significantly reduced on the highest dose only. Adverse effects were experienced by 1, 3 and 8 subjects respectively on the three doses. The most frequent was constipation which was of sufficient severity to cause three to withdraw from treatment. It is concluded that, of the three doses studied, the optimal daily dose of diltiazem for elderly patients is 180 mg/day.