Effect of diltiazem on exercise tolerance in patients with stable coronary artery disease and hypertension.

The present study aimed to investigate the effect of diltiazem on cardiovascular risk and exercise tolerance in patients with stable coronary artery disease and hypertension. From 2016 to 2018, 80 patients with stable coronary artery disease (5 < Gensini score < 20) and hypertension were enrolled into the present study. These patients were randomly divided into two groups: diltiazem group (Dil, 90 mg, bid), and control group (angiotensin-converting enzyme inhibitors (ACEI)/angiotensin II receptor blockers (ARB) for reducing blood pressure and β-receptor blockers for controlling heart rate). Liver and kidney function, heart rate variability (HRV), blood pressure variability (BPV) and bicycle exercise were measured at baseline and after six months. The incidence of cardiovascular events (re-hospitalization due to angina pectoris, acute myocardial infarction, and cardiogenic death) was also assessed. The differences in all indexes at baseline between these two groups were not statistically significant (P > 0.05, respectively). After six months of treatment, both groups of patients had significant improvements in HRV, BPV and exercise tolerance compared that before treatment (p < 0.05). The difference in the decrease in systolic blood pressure, improvement of HRV and BPV, and cardiovascular events between these two groups was not statistically significant (P = 0.588, 0.431, 0.152, 1.000, respectively). But the Dil group was significantly better than the control group in degree of heart rate decline, diastolic blood pressure decline, and improvement of ST segment depression (P < 0.001), and the improvement in exercise tolerance was also better than that of the control group. We found that diltiazem compared with ACEI/ARB and β-receptor blockers can further improve the exercise tolerance of patients with stable coronary artery disease and hypertension.