Tiapamil: an effective antihypertensive in the elderly?

Ten patients, mean age 79 (range 71 to 86 years) all with mild to moderate hypertension randomly received a single oral dose of the calcium antagonist tiapamil [Ro-11-1781; Roche] 450mg or placebo in a single-blind, crossover study. They then received tiapamil 450mg bid for a further 7 days.

A single dose of tiapamil was found to significantly (p < 0.001) reduce BP to 159/90mm Hg, whereas with placebo BP was 171/98mm Hg; likewis~,. the mean arterial pressure (MAP) significantly (p < 0.01) decreased from 133mm Hg after placebo to 122mm Hg after tiapamil. Heart rate did not significantly change.

After 7 days of tiapamil treatment, BP had fallen to 155/86mm Hg (p < 0.001) and MAP was 106mm Hg

(p < 0.001). The hourly BP profile over a 12-hour period showed that the antihypertensive effect was present for up to 12 hours postdosing.

Tiapamil was generally well tolerated. It appeared to reduce systolic BP to a greater extent than diastolic BP. This study suggests that calcium blockers may provide an effective form of treatment of hypertension in the elderly. Further studies on the sustained effect of tiapamil are required. Balansard, P.; Elklk, F.; Levenson, J.A.; Ciampi, M. and Sans, P,; British Journal of Clinical Pharmacology 18: 823-829 (Dec 1984)

6 INPHARMA® 16 Feb 1985 0156-2703/85/0216-0006/0$01.00/0 © ADIS Press