Structural and functional myocardial responses to chronic treatment with the Ca2+ blocker verapamil (Calan-SR) in hypertensive patients.
We wished to determine whether prolonged therapy with the Ca2+ channel blocker verapamil has beneficial structural and functional cardiac effects. Nine hypertensive outpatients [systolic blood pressure (SBP) 164 +/- 4 and diastolic BP (DBP) 103 +/- 4 mm Hg: men and women, blacks and whites, mean age 48.6 years] received 240-480 mg slow-release verapamil (Calan-SR) a day. BP, left ventricle (LV) wall thickness and mass, and mitral flow characteristics on echocardiography, and plasma catechols and renin were determined at 0, 5, 10, and 15 months. Patients were compared with 10 normotensive controls, of similar group composition (SBP 130 +/- 3 and DBP 82 +/- 1 mm Hg; age 47.2 years). In the hypertensive patients, SBP and DBP decreased significantly (p < 0.05), by 14 and 12 mm Hg, respectively, but remained well above that of controls and > 140/90 mm Hg. Diastolic LV septal thickness decreased from 15.3 +/- 0.6 to 14.5 +/- 1.1 mm (not significant), while diastolic LV posterior wall thickness (PWTd) decreased significantly (p < 0.05) from 15.7 +/- 0.6 to 14.1 +/- 0.7 mm after 8 months, but not to the value of the controls. LV diastolic and systolic and left atrial dimensions remained constant. Normalized LV mass, initially 60% greater than the controls, decreased slightly (11%) but nonsignificantly and remained above that of controls. Neither LV mass nor LV posterior wall thinning was correlated with reduction in BP. Patient peak systolic wall stress was initially significantly lower than that of controls.(ABSTRACT TRUNCATED AT 250 WORDS)
Howley
J W
JW
Department of Medicine, St. John Hospital, Detroit, Michigan.
Formolo
J M
JM
Penney
D G
DG
D001794:Blood Pressure / Q000187:drug effects*; D003692:Delayed-Action Preparations; D004452:Echocardiography / Q000187:drug effects; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects; D009206:Myocardium / Q000473:pathology*; D011446:Prospective Studies; D016277:Ventricular Function, Left / Q000187:drug effects; D014700:Verapamil / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*
D003692:Delayed-Action Preparations; D014700:Verapamil