title: Safety of controlled-onset extended-release verapamil in middle-aged and older patients with hypertension and coronary artery disease.
abstract: BACKGROUND
  Our purpose was to study the safety of controlled-onset, extended-release (COER) verapamil in patients with hypertension or coronary artery disease, with a focus on elderly patients.
  
  
  METHODS
  Adverse event data were pooled from 7 double-blind, multicenter, randomized trials including 1999 patients with hypertension or chronic stable angina pectoris. There were 1042 patients who received COER verapamil 180 to 540 mg once daily in the evening for up to 10 weeks, 373 patients who received placebo, and 584 who received an active comparator agent. Data were analyzed according to the following groups: all patients, patients with hypertension, patients with angina, older patients (>/=65 years old), and younger patients (<65 years old). Adverse event rates were compared across the treatment groups by the Fisher exact test.
  
  
  RESULTS
  In all patients combined, the incidence of constipation (13% vs 2%), dizziness (6% vs 2%), and back pain (3% vs 1%) was higher in patients treated with COER verapamil than with placebo. Patients with hypertension had more back pain (4% vs 1%) and constipation (12% vs 1%) with COER verapamil than with placebo, whereas patients with angina had more bradycardia (2.6% vs 0%), dizziness (8% vs 2%), and constipation (15% vs 3%). Older patients treated with COER verapamil had more bradycardia, constipation, dizziness, and fatigue and had fewer headaches compared with younger patients treated with COER verapamil. Second- or third-degree atrioventricular block was not observed after administration of COER verapamil in any subgroup.
  
  
  CONCLUSIONS
  These data demonstrate that COER verapamil has an acceptable safety profile that is largely unrelated to age in patients with hypertension or coronary artery disease.
authors.affiliation: Section of Hypertension and Clinical Pharmacology, University of Connecticut School of Medicine, Farmington, CT 06030-3940, USA. wwhite@nsol.uchc.edu
authors.forename: W B
authors.initials: WB
authors.lastname: White
authors.forename: M F
authors.initials: MF
authors.lastname: Johnson
authors.forename: R J
authors.initials: RJ
authors.lastname: Anders
authors.forename: W J
authors.initials: WJ
authors.lastname: Elliott
authors.forename: H R
authors.initials: HR
authors.lastname: Black
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000188:drug therapy*; D001416:Back Pain / Q000139:chemically induced; D003248:Constipation / Q000139:chemically induced / Q000517:prevention & control*; D003692:Delayed-Action Preparations; D004244:Dizziness / Q000139:chemically induced; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D014700:Verapamil / Q000008:administration & dosage* / Q000009:adverse effects*
chemical_list: D003692:Delayed-Action Preparations; D014700:Verapamil