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Short- and long-term treatment of mild to moderate hypertension with verapamil
Insights
Verapamil effectively lowers blood pressure in mild to moderate hypertension. A lower dosage (120 mg twice daily) is as effective as a higher dosage (three times daily) and may improve patient adherence.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Hypertension is a prevalent cardiovascular risk factor.
- Effective and safe antihypertensive medications are crucial for patient management.
Purpose of the Study:
- To evaluate the efficacy and safety of verapamil in patients with mild to moderate hypertension.
- To compare different verapamil dosages for blood pressure control.
Main Methods:
- A 3-month study involving 43 patients with mild to moderate hypertension.
- Initial treatment with verapamil (120 mg three times daily), with addition of althiazide and spironolactone for non-responders.
- A 1-year follow-up for 26 patients on verapamil alone, comparing dosages.
Main Results:
- Verapamil normalized blood pressure in 67% of patients within 1 month.
- Combination therapy further normalized blood pressure in 9 additional patients.
- Verapamil showed a mild decrease in heart rate; adverse effects were transient and mild.
- A dosage of 120 mg twice daily was as effective as three times daily over 1 year.
Conclusions:
- Verapamil is an effective and safe antihypertensive agent for mild to moderate hypertension.
- A verapamil dosage of 120 mg twice daily is recommended for improved patient compliance.
Abstract:
Forty-three patients with mild to moderate hypertension (supine diastolic blood pressure 95 to 115 mm Hg) were entered into a short-term (3 months) study. All received verapamil, 120 mg 3 times a day. After 1 month of treatment on verapamil alone, supine diastolic blood pressure was normalized (less than 95 mm Hg) in 29 patients (67%). These patients continued with verapamil at the same dosage. In 14 nonresponders (supine diastolic blood pressure greater than 95 mm Hg) a combination of althiazide (15 mg/day) and spironolactone (25 mg/day) was added. This resulted in diastolic blood pressure normalization in 9 additional patients. Verapamil induced a slight but moderate decrease in heart rate after 1 month, but no further decrease was observed thereafter. During the trial, 21% of patients reported adverse effects, mostly transient and mild. No patient had to discontinue treatment because of them. Twenty-six patients on verapamil alone were followed for 1 year. Systolic and diastolic blood pressure was adequately controlled in all patients except 1. In 13 the dosage was decreased to 120 mg 2 times a day. There were no significant differences in blood pressure between this group and patients given 120 mg 3 times a day. It is concluded that verapamil is an effective and safe antihypertensive agent in mildly to moderately hypertensive patients. Because a dosage of 120 mg 2 times a day was as effective as 120 mg 3 times a day, the former should be recommended, as it may improve patient compliance.