EFFECTS OF VERAPAMIL SR, TRANDOLAPRIL, AND THEIR FIXED COMBINATION ON24-H BLOOD-PRESSURE - THE VERATRAN STUDY

The Veratran study investigated the antihypertensive efficacy of verap amil sustained release (SR) (180 mg), trandolapril(1 mg), and their fi xed combination during a 24-h period. After a 4-week placebo run-in pe riod, 272 patients (age 49 +/- 9 years, mean +/- SD) with essential hy pertension and a clinic diastolic blood pressure greater than or equal to 100 mm Hg were randomized to verapamil, trandolapril, their fixed combination, or placebo for 8 weeks, according to a multicenter double -blind parallel group study design. Clinic and semiautomatic blood pre ssure at trough and 24-h ambulatory blood pressure were measured at th e end of run-in period and after 8 weeks of treatment. In the 234 pati ents included in the efficacy analysis, run-in clinic and semiautomati c blood pressures were reduced by verapamil, trandolapril, and combine d verapamil and trandolapril significantly more than by placebo. The r eductions obtained with the combination were significantly greater tha n those obtained by verapamil alone. Twenty-four-hour average blood pr essures were not modified by placebo and were reduced by 8/6 mm Hg (sy stolic/diastolic) by verapamil, 11/7 mm Hg by trandolapril, and 14/11 mm Hg by the combination of the two drugs. The differences between the effect of the combination and the combination components were, in mos t instances, statistically significant. The verapamil-trandolapril com bination was more effective also on day average blood pressure and sup erior to the monotherapies for the trough-to-peak ratio of the antihyp ertensive effect as well. Twenty-four-hour heart rate was slightly but significantly reduced by verapamil and the reduction was manifest in the group taking verapamil plus trandolapril. Thus, the antihypertensi ve treatment with the fixed verapamil SR-trandolapril combination is m ore effective and balanced over the 24 hours than the effect of the co mbination components administered alone. (C) 1997 American Journal of Hypertension, Ltd.