title: Efficacy of a fixed-dose combination of trandolapril-verapamil in patients with stage 2 hypertension inadequately controlled by monotherapy.
abstract: OBJECTIVE
  About 70% of hypertensive patients need more than one drug to control their blood pressure (BP). The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends a two-drug combination as initial drug therapy for patients with stage 2 hypertension. The aim of this study was to determine if a fixed-dose combination of trandolapril-verapamil is effective and safe in the treatment of stage 2 (moderate to severe) hypertension in hypertensive Mexican patients not controlled by monotherapy.
  
  
  METHODS
  Forty hypertensive patients with BP >160/100mm Hg despite >6 months of drug treatment were given the fixed-dose combination of trandolapril-verapamil (2mg/180mg) for 12 weeks. Before taking the drug, they measured their own blood pressure (self-measured BP [SMBP]) several times a day for 3 days using a validated Omrom HEM 713C BP measuring device. At the end of the 12-week treatment period, the patients performed a second series of SMBPs in the same way as before treatment. A washout period was not included because the patients did not have an adequate response to previous antihypertensive treatment. Antihypertensive control during the 3-day SMBP period was evaluated.
  
  
  RESULTS
  Patients experienced a significant reduction in mean BP (from 180/100mm Hg to 135/78mm Hg; p < 0.001). Seventy-five percent of patients reached their therapeutic goals (BP <140/90mm Hg). The SMBP records showed that BP values were maintained throughout the entire 3 days. One patient experienced headache and one had constipation; no patients discontinued the treatment.
  
  
  CONCLUSIONS
  A fixed-dose combination of trandolapril-verapamil seems to be an effective and safe option for the management of stage 2 hypertension in Mexican patients uncontrolled by monotherapy.
authors.affiliation: Hypertension Clinic, Hospital General de Ticomán SS DF, México DFTicomán Group for Hypertension Study, Hospital General de Ticomán SS DF, México DFDepartment of Molecular Biomedicine, Centro de Investigacion y Estudios Avanzados del IPN, Fellow, Consejo Nacional de Ciencia y Tecnologia (CONACYT) Mexico, Mexico DF.
authors.forename: Alberto Francisco
authors.initials: AF
authors.lastname: Rubio-Guerra
authors.forename: Adalberto
authors.initials: A
authors.lastname: Arceo-Navarro
authors.forename: José Juan
authors.initials: JJ
authors.lastname: Lozano-Nuevo
authors.forename: Germán
authors.initials: G
authors.lastname: Vargas-Ayala
authors.forename: Leticia
authors.initials: L
authors.lastname: Rodríguez-López
authors.forename: Luz María
authors.initials: LM
authors.lastname: Ramos-Brizuela