Verapamil in essential hypertension: a comparison with atenolol plus hydralazine

The effects of graded doses of verapamil were compared with those of a combination of atenolol and hydralazine in a double-blind, randomised, crossover trial in 16 patients with essential hypertension. During the placebo phase, mean arterial pressure (M.A.P.) was 123 +/- 17 mmHg. Verapamil (dose range 160-480 mg/day) lowered M.A.P. to 109 +/- 7 mmHg (p less than 0.01 vs placebo). The combination of atenolol (50-100 mg/day) and hydralazine (50-200 mg/day) lowered M.A.P. to 100 +/- 11 mmHg (p less than 0.001 vs placebo, p less than 0.05 vs verapamil). Neither regimen produced any deleterious effects on electrocardiographic intervals, echocardiographic indices of left ventricular function or plasma lipids. Verapamil was well tolerated and provided satisfactory alternative therapy in these patients with mild-to-moderate essential hypertension.