Verapamil SR trandolapril combination therapy for the elderly hypertensivepatient

A total of 254 elderly hypertensive patients (71 men and 183 women aged bet ween 63 and 92 years, diastolic blood pressure (DBP) 95-115 mm Hg inclusive ) were treated with the fixed combination of verapamil SR/trandolapril foll owing a 4-week single-blind placebo run-in period. Treatment was started wi th a response dependent 3-step dose titration period. All patients were ini tiated at dose step 1 (verapamil SR/trandolapril 120/0.5 mg o.d.) and if no t normalised (DBP <90 mm Hg) titrated at 4-weekly intervals over dose step 2 (verapamil SR/trandolapril 180/1 mg o.d.) to dose step 3 (verapamil SR/tr andolapril 180/2 mg o.d.) during the first 12 weeks. After 3 months of trea tment all patients not normalised were excluded from further participation in the study. The total duration of the treatment period was 6 months. Rout ine safety investigations were performed prior, during and on completion of the treatment period. Verapamil SR/trandolapril was highly effective in re ducing blood pressure. At individual last visit during active treatment (al so taking the non-responders into account), the mean reduction in SBP/DBP w as 21.9/17.1 mm Hg (95% CI 19.8-24.1/16.1-18.1 mm Hg), with most of this re duction occurring during the first 3 months of treatment. After 6 months, 8 1.9% of the patients enrolled showed normalisation of DBP (<90 mm Hg) and 8 5% were responders (normalisation and/or reduction in DBP by at least 10 mm Hg). Normalisation and responder rates appeared to be comparable when stra tified by age subgroups (63-69, 70-79 and greater than or equal to 80 years ) and were all greater than 80%. Verapamil SR/trandolapril was very well to lerated and there was no evidence of any clinically relevant changes in rou tine laboratory safety variables or resting EGG. In conclusion, the fixed d ose combination of verapamil SR/trandolapril is an effective and safe alter native treatment for the elderly hypertensive patient.