Chronotherapeutic delivery of verapamil in obese versus non-obese patients with essential hypertension.
BACKGROUND
The effect of controlled-onset, extended-release (COER) verapamil on haemodynamic parameters in obese and non-obese patients is evaluated in this analysis.


METHODS
Data were pooled from three clinical trials evaluating efficacy and tolerability of COER-verapamil. Hypertensive men and women (stage I to III) were randomised to COER-verapamil (180-540 mg at bedtime) or placebo for 4-8 weeks and stratified according to body mass index (BMI-obese > 28 kg/m2). Efficacy was assessed as change from baseline in blood pressure (BP), heart rate, and rate-pressure product during four time periods throughout the dosing interval. Safety and tolerability were assessed by monitoring all adverse events and changes in metabolic laboratory parameters.


RESULTS
Reductions in all haemodynamic parameters were significantly greater following COER-verapamil compared with placebo for all time periods. The haemodynamic effects of COER-verapamil in obese (n = 166, BMI = 32.8 kg/m2) and non-obese patients (n = 115, BMI = 25.0 kg/m2) were similar. COER-verapamil was well tolerated in both subgroups, but the incidence of constipation was significantly less in obese patients (P < 0.001).


CONCLUSIONS
COER-verapamil is effective in reducing BP, heart rate, and rate-pressure product independently of BMI.
White
W B
WB
Section of Hypertension and Clinical Pharmacology, University of Connecticut School of Medicine, CT, USA.
Elliott
W J
WJ
Johnson
M F
MF
Black
H R
HR
D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D002121:Calcium Channel Blockers / Q000008:administration & dosage* / Q000627:therapeutic use*; D019454:Chronotherapy; D003692:Delayed-Action Preparations; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D014700:Verapamil / Q000008:administration & dosage* / Q000627:therapeutic use*
D002121:Calcium Channel Blockers; D003692:Delayed-Action Preparations; D014700:Verapamil