Verapamil: a first-line agent for hypertension? A slow release formulation effectively reduces BP ...

In a large open study, 1412 ambulatory patients with mild to moderate hypertension received slow release verapamil 240mg once-daily for 12 weeks.

Mean BP was Significantly reduced from baseline after 2 (157/93.6 vs 171.82/1 03.55mm Hg) and 12 (147.2/86.33mm Hg) weeks of therapy. The decrease in BP was not Significantly different between elderly (> 65 years) and younger patients, despite a higher baseline BP in the elderly. HR decreased by a mean of 4.8 beats/min during the first 5 weeks, and by 0.95 beats/min by week 12. 1099 (78%) and 950 (67%) patients were controlled by verapamil monotherapy at weeks 2 and 12, respectively. Adverse effects, generally mild and transient, included constipation, gastric complaints, headache, flushing and fainting: therapy was withdrawn in 15 cases.

Thus, the safety and efficacy of slow release verapamil 240 mg/day ' ... emphasizes the potential use of calcium channel blocke,s In essential hypertension as fI,st-step drugs mainly In mild to mode,ate hypertension'. Gomez Paluelo C. Perez NaranlO J. RUiz Martinez I. Collaborative Group of the Spamsh League for the Fight Against Hypertension Treatment of mild to moderate hypertension With verapamll slow·release In outpahents Journal of Cardiovascular Pharmacology 13 (Suppl. 4) 550·552 1989 ...

. . . and is well tolerated in mild, moderate and severe hypertension ...

Slow release verapamil ('Isoptin RR') 240-480 mg/day was administered to 4247 patients (mean age of 56.6 years) with mild, moderate or severe hypertension; dosage was titrated according to response. Goal diastolic BP (~ 90mm Hg) was achieved in 90, 77 and 61 % of evaluable patients (4176) with hypertension of mild, moderate or severe intensity, respectively. Verapamil was well­tolerated. Adverse effects, reported in 480 patients, included constipation, dizziness and headache, and necessitated the discontinuation of therapy in 139 patients. Speders S, Sosna J. Schumacher A. Pfenmgsdorf G Efficacy and safety of verapamil SR 240mg In essential hypertension: results of a multlcentroc phase IV study Journal of Cardiovascular Pharmacology 13 (Suppl. 4) S47-S49, 1989 ...

• . . and a combination of verapamil and methyldopa is effective in refractory cases

20 patients with resistant hypertension and diastolic BP > 100mm Hg despite continuing regular treatment, received increasing doses of verapamil (240-480mg) and methyldopa (500-1500mg) + hydrochlorothiazide 50 mg/day; regular antihypertensives were gradually withdrawn, Of 16 patients who completed the 3-year study, 15 achieved goal diastolic BP (~ 95mm Hg), Mean BP was significantly reduced from baseline (150/90 vs 187/118mm Hg). Adverse effects were mild and transient.

0156-2703/89/0722-0009/0S01.(JO/O @ ADIS Press

Spritzer N. Sprotzer TS, Rodrigues R Treatment of resistant hypertension 3 years of follow·up With the combination of verapamil and methyldopa. Journal of Cardiovascular Pharmacology 13 (Suppl. 4) S65-567.1989 ....

INPHARMA" 22 Jul1989 9