S. Oren et al., ANTIHYPERTENSIVE EFFICACY OF A ONCE-A-DAY VERAPAMIL SR TRANDOLAPRIL COMBINATION, International journal of cardiology, 55(1), 1996, pp. 97-102
Twenty-one patients with a sitting diastolic blood pressure between 10
0 and 114 mmHg after a single-blind 2-week placebo run-in period, star
ted treatment under open conditions with the fixed combination of vera
pamil SR/trandolapril 180/1 mg o.d. for a period of 8 weeks. Patients
whose conventionally measured diastolic blood pressure after 4 weeks'
treatment was not normalised (diastolic blood pressure <90 mmHg) recei
ved the higher dosage (verapamil SR/trandolapril 180/2 mg o.d.) for a
further 4 weeks. Clinical evaluations including measurement of blood p
ressure were performed every 2 weeks. A 24-h ambulatory blood pressure
monitoring (ABPM) was performed at weeks 0, 4 and 8 (end of the study
). The mean office blood pressure decreased from 155+/-11/104+/-4 mmHg
at baseline to 139+/-9/89+/-6 mmHg at week 8. In 12 patients (60%), t
he diastolic blood pressure was normalised after week 4. In eight pati
ents, the dosage was increased and, of these, a further 25% were norma
lised at week 8. Response, defined as a reduction of diastolic blood p
ressure to less than or similar to 90 mmHg (normalisation) or a decrea
se of at least 10 mmHg compared to baseline, was recorded in 18 patien
ts (90%). The mean 24-h ABPM was reduced from 143+/-15/85 +/-9 mmHg at
baseline to 131+/-11/77+/-8 mmHg at week 8. The average systolic and
diastolic blood pressure was reduced by a statistically significant am
ount (11/9 mmHg) during the day (8.00 am-10.00 pm) and 11/7 mmHg durin
g the night (10.00 pm-8.00 am). Diurnal variation did not change. Only
mild to moderate adverse events such as slight isolated elevations of
SGPT, SCOT and potassium were observed. Two patients discontinued the
study prematurely due to impotence which began during the placebo run
-in period. No adverse events were serious or required any additional
medical treatment. The fixed combination of verapamil SR and trandolap
ril appear to be a very effective and well-tolerated once-a-day antihy
pertensive medication.