Treatment of angina pectoris and hypertension with sustained-release calcium channel-blocking drugs.

Sustained-release diltiazem (D-SR) and sustained-release verapamil (V-SR) when given twice a day have been successfully used to treat both essential hypertension and angina pectoris. Review of available studies indicates that 120 to 180 mg D-SR twice a day and 240 mg V-SR once or twice a day can lower diastolic pressure in 40% to 80% of patients with essential hypertension and that the drugs may be especially useful in patients with low-renin hypertension such as elderly and black populations. D-SR and V-SR prolong treadmill capacity and reduce frequency of angina in patients with stable effort angina. Improvement is mediated primarily by a reduction in resting and submaximal exercise heart rate. Biopharmaceutics of D-SR and V-SR feature a prolonged apparent plasma half-life and reduced peak-to-trough plasma concentration ratios during steady-state dosing.