Diltiazem appears to be a suitable alternative antihypertensive drug in elderly patients when diuretics are contraindicated or in those with concomitant conditions, such as angina pectoris and peripheral vascular disease. The drug appears particularly useful as an alternative to diuretics in elderly Black patients.
The role of diltiazem relative to that of other groups of alternative first-line antihypertensives has yet to be defined in the elderly population. Available evidence suggests that diltiazem lowers blood pressure at least as effectively as other drugs. Choice of drug may, therefore, be guided by the presence of contraindications and concomitant conditions.
Diltiazem is generally well tolerated, with the most common adverse effects being those typical of a vasodilator. However, it should be avoided in patients with cardiac conduction disturbances and left ventricular dysfunction since it may exacerbate these conditions.