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Long-term results with verapamil in essential hypertension and its influence on serum lipids
Insights
Verapamil effectively lowers blood pressure with minimal side effects like electrolyte or lipid changes. This calcium-channel blocker offers a safe treatment option for hypertension, with constipation being the primary adverse effect.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Hypertension treatment reduces cardiovascular and renal complications.
- Some antihypertensive drugs cause adverse metabolic and quality-of-life effects.
- Newer agents require evaluation of overall impact beyond blood pressure reduction.
Purpose of the Study:
- To assess the efficacy and safety of verapamil as an antihypertensive agent.
- To evaluate verapamil's long-term effects on tolerance, electrolytes, and serum lipids.
Main Methods:
- A study involving 75 patients followed for over 1 year.
- Verapamil dosage ranged from 80-160 mg, 3 times daily.
- Serum lipid levels were analyzed in 15 patients before and after 3 months of treatment.
Main Results:
- Verapamil demonstrated a dose-dependent reduction in blood pressure with minimal postural effects.
- No significant changes in serum electrolytes or creatinine clearance were observed.
- No adverse changes in cholesterol, triglycerides, or high-density lipoproteins were noted; constipation was the main side effect.
Conclusions:
- Verapamil is an effective antihypertensive with a rapid onset and no developed tolerance over prolonged use.
- It shows a favorable safety profile, with no adverse effects on electrolytes or serum lipids.
- Verapamil presents a viable treatment option for hypertension, with constipation as the primary limiting factor.
Abstract:
Many studies have confirmed that the treatment of mild and moderate hypertension reduces mortality and morbidity from cardiovascular accidents and cardiac and renal failure; more recent studies suggest that there is some beneficial effect on ischemic heart disease. The harmful metabolic effects of some hypotensive agents on serum potassium, magnesium, uric acid, glucose, renin and lipids might reduce the beneficial effect of controlling raised blood pressure. Also, the adverse effects associated with most antihypertensive drugs have decreased quality of life and, possibly, compliance in many patients. In assessing the value of newer antihypertensive agents, other effects of the drugs must be taken into account. The calcium-channel antagonist verapamil produces a dose-dependent reduction in blood pressure with little postural effect. There is little change in heart rate and the major antihypertensive effect results from a decrease in peripheral vascular resistance, with no accompanying increase in cardiac output. In 75 patients followed for more than 1 year, tolerance to verapamil did not appear to develop, nor were there any significant changes in serum electrolytes or creatinine clearance. Fasting serum lipid levels were measured in 15 patients before and after 3 months of treatment with verapamil (80 to 160 mg, 3 times a day); there was no change in cholesterol, triglycerides or high-density lipoproteins. Verapamil is, therefore, an effective hypotensive agent with a rapid onset of action. Tolerance does not develop with prolonged use, nor does it appear to affect electrolytes or serum lipids adversely. Constipation appears to be its only limiting adverse effect.