Treatment of mild to moderate hypertension with verapamil slow-release in outpatients. Collaborative Group of the Spanish League for the Fight Against Hypertension.
The efficacy of verapamil, a calcium channel blocker in slow-release form, 240 mg once a day, was assessed in 1,412 ambulatory, mildly to moderately hypertensive patients. Blood pressure decreased from 171.82 +/- 17/103.55 +/- 6 mm Hg at week 0 to 157 +/- 15/93.6 +/- 8 mm Hg at 2 weeks (p less than 0.001) in 78% of patients. At week 12 there were 1,249 patients (88%) controlled with therapy, either with verapamil alone (950 patients, 67%) or plus additional diuretic (21%). Blood pressure showed a mean decrease of 24.6 mm Hg in systolic and 17.2 mm Hg in diastolic pressure at week 12. Heart rate decreased from 81.4 +/- 11 beats/min at week 0 to 75.69 +/- 8.5 beats/min at week 12 (p less than 0.05). There were no statistical differences in the effect on diastolic blood pressure between elderly (greater than 65 years) and nonelderly patients in the study, although the elderly showed higher baseline systolic pressure (178.27 +/- 17 mm Hg vs. 168.97 +/- 16 mm Hg, p less than 0.001) than did nonelderly patients. Verapamil therapy produced a similar effect on systolic pressure (p = NS) in younger patients (23.96 mm Hg decrement) and in the elderly (25.93 mm Hg decrement). The overall incidence of adverse reactions was 16.58%, accounting for 1.06% of patients' withdrawals. Constipation (5%) was the most common side effect. We conclude that slow-release verapamil, 240 mg once a day, is an effective therapeutic alternative in systemic hypertension, and must be included in the first step of antihypertensive therapy.
Gómez Pajuelo
C
C
Servicio de Cardiología, Hospital 1 de Octubre, Madrid, Spain.
Pérez Naranjo
J
J
Ruiz Martínez
I
I
D000368:Aged; D000375:Aging / Q000502:physiology; D001794:Blood Pressure / Q000187:drug effects; D003692:Delayed-Action Preparations; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012737:Sex Factors; D014700:Verapamil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D003692:Delayed-Action Preparations; D014700:Verapamil