ANTIHYPERTENSIVE EFFICACY OF A ONCE-A-DAY VERAPAMIL SR TRANDOLAPRIL COMBINATION

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.