EFFECTS OF MONOTHERAPY WITH SUSTAINED-RELEASE VERAPAMIL ON BLOOD-PRESSURE, LIPID-LEVELS, RENAL-FUNCTION, DIABETIC CONTROL, AND PATIENT WELL-BEING IN PATIENTS WITH MILD-TO-MODERATE HYPERTENSION

The effects of sustained-release (SR) verapamil (Isoptin(R) SR) monotherapy on blood pressure (BP), lipid levels, renal function, diabetic control, and patient well-being- were investigated in an open-label multicenter trial of 507 patients with mild or moderate hypertension. Newly diagnosed and previously treated patients received SR verapamil 240 mg once daily for 6 weeks, with the option of titrating dosage to a maximum of 180 mg/day. Equal numbers of men and women (251 men, 251 women, 5 not reported) with an average age of 60 years were enrolled in the study. The greatest decreases in BP were achieved between baseline and week 2, when (mean +/- SD) BP fell from 163 +/- 20 mmHg systolic (SBP)/98 +/- 9 mmHg diastolic (DBP) to 149 +/- 17 mmHg SBP/88 +/- 9 mmHg DBP. Blood pressure readings after 6 weeks of treatment were 147 +/- 17 mmHg SBP/86 +/- 9 mmHg DBP. The mean percentage decrease in BP by week 6 was 9.24% for SBP and 12.21% for DBP. SR verapamil was found to be as efficacious in patients age >64 as in younger patients. No significant difference in BP response was observed when patients were stratified by age. Overall, 85% of patients attained goal BP (ie, DBP less-than-or-equal-to 90 mmHg or a greater-than-or-equal-to 10-mmHg decrease in DBP). Target BP was reached by 80% of patients with mild hypertension at baseline and 87% of those with moderate hypertension. Treatment with SR verapamil had a beneficial effect on lipid levels and patient well-being; no effects on renal function or glycemic control were noted. Side effects were reported by 114 (22.5%) patients; the most commonly reported effect was mild constipation (10.7%). The authors conclude that SR verapamil is a safe and effective drug in the treatment of hypertension.