What blood pressure should be maintained to hold Cardizem (Diltiazem)?

From the Guidelines

Cardizem (diltiazem) should be held if the systolic blood pressure falls below 90 mmHg, but the ideal blood pressure to maintain while taking this medication is less than 140/90 mmHg, with consideration to lower it further to less than 130/80 mmHg in certain cases, as recommended by the American Heart Association 1. When considering the management of blood pressure in patients taking Cardizem, it's essential to weigh the benefits of blood pressure control against the potential risks of hypotension.

• The medication works by relaxing blood vessels and slowing heart rate, which can lower blood pressure and potentially cause dangerous symptoms like dizziness, fainting, or inadequate blood flow to vital organs if blood pressure becomes too low.
• The American Heart Association recommends a target blood pressure of less than 140/90 mmHg, but suggests considering a lower target of less than 130/80 mmHg in certain cases, such as patients with coronary artery disease and heart failure 1.
• In patients with elevated diastolic blood pressure and coronary artery disease, the blood pressure should be lowered slowly to avoid causing very low diastolic blood pressure values, which can lead to myocardial ischemia and worsening heart failure 1.
• It's crucial to monitor blood pressure and heart rate regularly while taking Cardizem and to contact a healthcare provider promptly if any concerns arise, as sudden cessation of the medication can cause a rebound effect and worsen the condition being treated.
• The most recent and highest quality study, published in 2015, provides the best guidance on managing blood pressure in patients taking Cardizem, and its recommendations should be prioritized over older studies 1.

From the FDA Drug Label

• Patients with hypotension (less than 90 mm Hg systolic) The blood pressure should be at least 90 mm Hg systolic to hold Cardizem (Diltiazem) 2.

From the Research

Blood Pressure Maintenance for Cardizem (Diltiazem) Administration

To maintain Cardizem (Diltiazem) administration, the following blood pressure levels should be considered:

• The hypotensive effect of diltiazem was investigated in several studies, which showed that it can effectively lower blood pressure in patients with essential hypertension 3, 4, 5.
• A study published in the European journal of clinical pharmacology found that diltiazem decreased blood pressure from 164 +/- 22/98 +/- 8 to 144 +/- 15/86 +/- 9 mmHg in patients with essential hypertension 3.
• Another study published in the International journal of clinical pharmacology, therapy, and toxicology found that diltiazem HCl exhibited a hypotensive effect on systolic pressure in 88.9% of patients and on diastolic pressure in 66.7% of patients 4.
• A placebo-controlled comparison of diltiazem and amlodipine monotherapy in essential hypertension using 24-h ambulatory monitoring found that diltiazem significantly reduced blood pressure, with end-of-phase mean clinic sitting blood pressures of 146/95 mmHg and end-of-phase mean 24-h ambulatory blood pressures of 143/86 mmHg 5.
• However, the ideal blood pressure level to maintain while taking Cardizem (Diltiazem) is not explicitly stated in these studies, but it can be inferred that a blood pressure level below 140/90 mmHg is desirable, as recommended by major guidelines on hypertension 6.

Key Findings

• Diltiazem can effectively lower blood pressure in patients with essential hypertension.
• The hypotensive effect of diltiazem was observed in several studies, with significant reductions in blood pressure.
• The ideal blood pressure level to maintain while taking Cardizem (Diltiazem) is not explicitly stated, but a level below 140/90 mmHg is recommended by major guidelines on hypertension.