A COMPARATIVE-STUDY OF AMLODIPINE AND VERAPAMIL IN HYPERTENSIVE PATIENTS UNDERGOING HEMODIALYSIS

The aim of this study was to compare the antihypertensive effects of a mlodipine and verapamil in uraemic patients undergoing chronic haemodi alysis. After a 1-week drug washout phase, 40 patients (30 males, 10 f emales; mean age 57.18 +/- 13.4 years) were randomised to 12 weeks of treatment with amlodipine 5 mg/day (21 patients) or verapamil 120 mg/d ay (19 patients). Dosages were doubled after 4 weeks if adequate blood pressure control (diastolic blood pressure less than or equal to 90 m m Hg) had not been achieved. Haemodialysis was performed 3 times a wee k for a total of 12 hours. After 4 weeks of treatment, mean systolic a nd diastolic blood pressures were significantly lower (p < 0.001) than baseline values in both groups. On treatment completion (week 12), th e final reduction in systolic/diastolic blood pressure in the amlodipi ne group was 21/23 mm Hg, and in the verapamil group it was 17/21 mm H g. Normal values (diastolic blood pressure < 90 mm Hg) were reached in 81% and 74% of the amlodipine and verapamil groups, respectively. Hea rt rates remained unchanged in patients treated with amlodipine, but t hose receiving the higher dosage of verapamil experienced significant increases during the latter part of the study. The incidence of advers e events was low with both drugs and similar to that seen in nonuraemi c hypertensive patients. Thus, the results of this study su st that am lodipine is a well tolerated and effective treatment for arterial hype rtension in patients with renal failure undergoing haemodialysis.