CLINICAL-STUDY OF THE ASSOCIATION OF VERAPAMIL AND CAPTOPRIL IN HYPERTENSIVE PATIENTS NOT CONTROLLED WITH MONOTHERAPY - EVALUATION BY THE 24-HOUR AMBULATORY BLOOD-PRESSURE MONITORING

BACKGROUND: By measuring ambulatory blood pressure monitoring (ABPM), the pharmacologic association of verapamil plus captopril in essential hypertensive patients not responding to isolated monotherapy of these drugs was studied since a synergism has been described between these two drugs. METHODS: A lineal clinical trial with a previous period of selection (PeSe) in which verapamil and captopris were administered in two consecutive phases was carried out in 57 essential hypertensive p atients of 52 +/- 19 years of age with those controlling their blood p ressure (BP) being excluded. Following a lavage phase the remaining su bjects were included in the experimental period (ExPe) in wash out the association of verapamil 120 mg + captopril 25 mg was administered an d if the BP was not controlled this was increased to 240 mg + 50 mg, r espectively. ABPM was performed prior to and at the end of the ExPe. R ESULTS: Of the 57 patients 21 were excluded in the SePe due to control or adverse effects. Of the 26 individuals who passed into the ExPe 20 presented mild-moderate HTA (M-HTA) and 6 severe HTA (S-HTA). In the M-HTA group, the reduction of BP (in mmHg) was 157 +/- 15/106 +/- 5 to 147 +/- 12/97 +/- 7 (p < 0.05/p < 0.001), five controlled BP, in the remaining subjects the reduction in the following phase was 150 +/- 11 /100 +/- 6 at 136 +/- 11/93 +/- 6 (p < 0.01/p < 0.01). In the S-HTA gr oup the BP descended in the ExPe from 184 +/- 15/121 +/- 6 to 167 +/-2 4/107 +/- 10 (p < 0.05/p < 0.05). The 24 hour measurement of BP in the ExPe decreased from 140 +/- 13/96 +/- 8 to 124 +/- 10/86 +/- 7 (p < 0 .001/p < 0.001). BP descended significantly in all the hours with the exception of the hours 24, 1, 6, 7, and 5. CONCLUSIONS: The associatio n of verapamil-captopril demonstrates efficacy and synergism in hypert ensive patients previously uncontrolled by monotherapy of these drugs.