A modified isometric test to evaluate blood pressure control with once-daily slow-release verapamil

Blood pressure at rest is not predictive of round-the-clock values. Blood pressure should therefore be measured during effort to evaluate hypertension and its response to treatment. The effect of sustained-release verapamil (240 mg taken once a day) on blood pressure at rest and during isometric effort was therefore investigated. Overall, verapamil reduced blood pressure significantly in 41 of 45 hypertensive patients: the mean systolic blood pressure at rest (+/- SD) fell from 151 +/- 35 mmHg to 137 +/- 13 mmHg (P < 0.001) and the diastolic blood pressure from 97 +/- 21 mmHg to 83 +/- 7 mmHg (P < 0.001), while the systolic blood pressure during isometric effort fell from 186 +/- 23 mmHg to 156 +/- 13 mmHg (P < 0.001) and the diastolic blood pressure from 118 +/- 14 mmHg to 95 +/- 8 mmHg (P < 0.001). The simple, inexpensive handgrip method described is cost-effective and strongly recommended as an integral part of the evaluation of hypertensive patients. The combination of a drug to which compliance is good and a simple method of blood pressure evaluation should result in improved effectiveness of treatment in the long term.