VERAPAMIL AND NIFEDIPINE IN COMBINATION FOR THE TREATMENT OF HYPERTENSION

The authors examined the efficacy and safety of the combination of ver apamil and nifedipine in the control of hypertension. Retrospective an alysis of blood pressures was obtained on 50 patients who had historic ally documented essential hypertension and were receiving verapamil an d nifedipine. The patients had moderate to severe hypertension; 27 of 50 (54%) were uncontrolled on prescribed regimens of two or more separ ate classes of drugs. Control was defined by the ability to maintain a blood pressure of less than or equal to 160/90 by providing doses of verapamil (max: 480 mg/day) and nifedipine (max: 180 mg/day). Twenty-n ine (58%) were black and 21 (42%) were white. Ages ranged from 16 to 8 4 years. Mean duration of therapy was 1-2 years. Only 3 of 50 (6%) wer e control failures after providing verapamil and nifedipine. Three of 50 (6%) were discontinued because of side effects reversible hepatitis (2) and rash (1). There were no serious adverse events, i.e., CHF or arrhythmias. Manageable ankle edema was seen in 14 of 50 (28%) patient s. Verapamil and nifedipine, a combination of a dihydropyridine and a non-dihydropyridine calcium antagonist, was effective and safe in this group of patients with difficult-to-manage hypertension.