Evaluation of the antihypertensive efficacy and safety of using sustained release verapamil in elderly subjects using ambulatory blood pressure monitoring

OBJECTIVE: Calcium antagonists are commonly used drugs in the treatment of hypertension in elderly patients. One of the drugs of this group is verapamil. Especially its slow release formula is convenient for use in elderly patients (drug is given once daily). The aim of our study was to evaluate the antihypertensive efficacy of 240 mg slow release verapamil given once daily in elderly hypertensives using ambulatory blood pressure monitoring (ABPM). We also evaluated the safety of this slow release formula using trough to peak ratio. DESIGN AND METHODS: Twenty hypertensives of mean age 67.5 +/- 5.3 were enrolled into the study. Our study was performed using double-blind, placebo-controlled cross-over study design. After a 2-week wash-out period 24-hour ABPM was performed for the first time and then twice: after 2 weeks of placebo or 240 verapamil slow-release and after 2 weeks of verapamil or placebo treatment. The readings prior to and after the treatment were taken using the same procedure. Blood pressure measurements were recorded every 15 minutes between 7.00 and 23.00 and every 30 minutes between 23.00 and 7.00. RESULTS: Verapamil treatment statistically significantly reduced (p < 0.05) mean 24 hour systolic blood pressure from 148.88 +/- 7.56 mmHg to 132.24 +/- 6.13 mmHg and diastolic respectively from 96.68 +/- 6.05 to 83.04 +/- 5.40 mmHg. Heart rate decreased from 77.16 +/- 3.84 BPM to 68.88 +/- 4.41 BPM. Placebo-corrected trough to peak ratio was 70% for systolic blood pressure.