VERAPAMIL AND TRANDOLAPRIL ALONE AND IN FIXED COMBINATION ON 24-HOUR AMBULATORY BLOOD-PRESSURE PROFILES OF PATIENTS WITH MODERATE ESSENTIAL-HYPERTENSION

The 24-hour ambulatory blood pressure response to daily treatment with verapamil sustained release (SR) 180 mg once daily, trandolapril 2 mg once daily, or verapamil SR 180 mg/trandolapril 2 mg once daily was i nvestigated in a randomized, double-masked study. This study consisted of a subset of patients of a larger study. Ninety patients (mean age, 55 years) with moderate essential hypertension were enrolled in the s tudy; 24 received verapamil SR 180 mg once daily, 35 received trandola pril 2 mg once daily, and 31 received verapamil SR 180 mg/trandolapril 2 mg once daily therapy for 8 weeks. The 24-hour ambulatory blood pre ssure measurements were done at baseline and at the end of the treatme nt period. Treatment with verapamil SR/trandolapril combination therap y produced significantly greater reductions in diastolic blood pressur e (DBP) and systolic blood pressure (SBP) than either monotherapy over the 24-hour period, and during the daytime and nighttime monitoring p eriods (adjusted mean reduction in blood pressure over 24 hours: 18.1/ 11.1 mm Hg vs 10.7/6.4 mm Hg on trandolapril monotherapy vs 6.9/6.7 mm Hg on verapamil SR monotherapy. Blood pressure remained within the no rmal range (DBP <90 mm Hg, SEP <140 mm Hg) longer on combination thera py than on either monotherapy. Combination therapy had the most pronou nced effect on blunting the early morning rise in blood pressure. Vera pamil SR/trandolapril combination therapy may be an appropriate treatm ent option in patients with moderate essential hypertension, particula rly in those who have a tendency toward early morning rise in blood pr essure.