Cardiovascular Drugs and Therapy

, Volume 4, Issue 6, pp 1501–1507 | Cite as

Verapamil 240 SR versus verapamil 120 SR in arterial hypertension. A randomized double-blind, placebo-controlled study with 24-hour ambulatory blood pressure monitoring

  • Luigi Corea
  • Maurizio Bentivoglio
  • Silvano Berioli
  • Carlo Bianchini
  • Ketty Savino
  • Marco Sardina


Fifteen patients (6 males, 9 females), age range 36–70 years, were enrolled in a randomized, double-blind, placebo-controlled study according to a Latin-square design, with the aim of comparing 24-hour blood pressure profiles after three 15-day treatment periods with placebo, verapamil SR 120 mg (V120 SR) given twice daily (bid), and verapamil SR 240 mg (V240 SR) given once daily (od.) All of the patients were diagnosed as mild or moderate essential hypertensives on the basis of standard casual recordings. Noninvasive 24-hour ambulatory blood pressure (BP) monitoring was performed with an ICR Spacelab 5200 automatic device. In comparison with placebo, a clinically and statistically significant reduction in both systolic and diastolic BP over 24 hours was obtained with both active treatments. Comparison of the two active treatments shows that V240 SR led to a greater reduction in systolic and diastolic BP than V120 SR. No changes in heart rate were observed. Both treatments were well tolerated. In conclusion, both verapamil regimens proved to be effective and safe in treating essential hypertensives, with V240 SR giving better 24-hour BP control.

Key Words

essential hypertension verapamil calcium antagonists ambulatory monitoring Fourier regression 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Frishman WH, Charlap S, Michelson EL. Calcium channel blockers in systemic hypertension.Am J Cardiol 1986;58:157–160.PubMedGoogle Scholar
  2. 2.
    Spivack C, Ocken S, Frishman WH. Calcium antagonists. Clinical use in the treatment of systemic hypertension.Drugs 1985;25:154–177.Google Scholar
  3. 3.
    Midtbo K, Hals O, Lauve O. Verapamil slow-release in the treatment of hypertension. In:Hypertension—the next decade. Berlin Icc, 10–11 October 1985, Edinburgh: Churchill Livingstone, 1985:85–93.Google Scholar
  4. 4.
    Cruickshank JK, Anderson NM, Wadsworth J, et al. Treating hypertension in black compared with white non-insulin dependent diabetics: A double blind trial of verapamil and metoprolol.Br. Med J 1988;5,297:1155–1159.Google Scholar
  5. 5.
    Salmela PI, Gordin A, Salo H et al. Comparisons of verapamil administration twice and three times daily in hypetension.Ann Clin Res 1988;20,3:195–200.PubMedGoogle Scholar
  6. 6.
    Olivan-Martinez J, Lopez-Chozas JM, Miranda MJ, et al. Verapamil versus propranolol in the treatment of systemic hypertension. In:Hypertension-the next decade. Berlin Icc, 10–11 October 1985, Edinburgh: Churchill Livingstone, 1985:285–288.Google Scholar
  7. 7.
    Leonetti G, Sala C, Bianchini C, et al. Antihypertensive and renal effects of orally administered verapamil.Eur J Clin Pharmacol 1980;18:375–382.Google Scholar
  8. 8.
    Weber MA, Cheung DG, Graettinger WF, et al. Characterization of antihypertensive therapy by whole-day blood pressure monitoring.JAMA 1988;259:3281–3285.PubMedGoogle Scholar
  9. 9.
    Lattuada SL, Antivalle M, Rindi M, et al. Slow-release metoprolol and nifedipine in essential hypertension: 24 hour noninvasive ambulatory blood pressure monitoring.J Cardiovasc Pharmacol 1987;10(suppl 10):S99-S101.Google Scholar
  10. 10.
    Edmonds D, Würth JP, Baumgart P, et al. Twenty-fourhour monitoring of blood pressure during calcium antagonist therapy. In:Hypertension-the next decade. Berlin Icc, 10–11 October 1985. Edinburgh: Churchill Livingstone, 1985:94–100.Google Scholar
  11. 11.
    Geronimo G, Damiani S, Ferrucci A, et al. Clonidine before sleeping minimized blood pressure rise upon awakening. In: UEUP ed.,Proceedings of the Fifth International Symposium on Ambulatory Monitoring. ISAM, 1985:273–279.Google Scholar
  12. 12.
    Gould BA, Mann S, Kieso M, et al. The role of a slow channel inhibitor, verapamil, in the management of hypertension.Acta Med Scand 1981 (Suppl 6):S117-S123.Google Scholar
  13. 13.
    Reinfrank J, Eckardt A, Hahn KJ. A long-term multicentre study of verapamil SR 240 mg in hypertension. In:Hypertension-the next decade. Berlin ICC, 10–11 October 1985, Edmburgh: Churchill Livingstone, 1985:307–313.Google Scholar
  14. 14.
    Leonetti G, Cuspidi C, Sampieri L, et al. Comparison of cardiovascular, renal and humoral effects of acute administration of two calcium channel blockers in normotensive and hypertensive subjects.J Cardiovasc Pharmacol 1982;4:S319-S324.PubMedGoogle Scholar
  15. 15.
    Marlettini MG, Salomone T, Agostini D, et al. Long-term treatment of primary hypertension with verapamil.Curr Ther Res 1986;39, 1:59–65.Google Scholar
  16. 16.
    Gomez Pajuelo C, Perez Naranjo J, Ruiz Martinez I. Treatment of mild to moderate hypertension with verapamil slow-release in outpatients.J Cardiovasc Pharmacol 1989;13 (Suppl 4P):S50-S52.Google Scholar
  17. 17.
    Speders S, Sosna J, Schumacher A, et al. Efficacy and safety of verapamil SR 240 mg in essential hypertension: Results of a multicentric phase IV study.J Cardiovasc Pharmacol 1989;13(Suppl 4P):S47–49.Google Scholar
  18. 18.
    Novo S, Alaimo G, Albrignani MG, et al. Noninvasive blood pressure monitoring evaluation of verapamil slow-release 240 mg antihypertensive effectiveness.J Cardiovasc Pharmacol 1989;(Suppl 4P):S38-S41.Google Scholar
  19. 19.
    McCormack PM, Latham AN, Mee F. et al. The efficacy and duration of action of sustained-release verapamil in essential hypertension.J Cardiovasc Pharmacol 1989;(Suppl 4P): S34-S37.Google Scholar
  20. 20.
    Cardillo C, Savi L, Musumeci V, et al. Casual versus 24-hour ambulatory blood pressure recording in the evaluation of chronic administration of sustained-release verapamil.J Human Hypertens 1988;14:281–285.Google Scholar
  21. 21.
    Nayler WG,Calcium antagonists. London: Academic Press, 1988:118.Google Scholar
  22. 22.
    Halberg F, Halberg E, Carandente F, et al Dynamic indices from blood pressure monitoring for prevention, diagnosis and therapy. In: Cleup, ed.,Proceedings of the Fifth International Symposium on Ambulatory Monitoring. ISAM, 1985:205–219.Google Scholar
  23. 23.
    Altman DG. Statistical methods for blood pressure variability measurement. In: Magometschnigg D, Hitzenberger G, eds.Blood pressure variability. Austrian Working Group on Clinical Pharmacology 9th Symposium. Uhlen, 1983:32–36.Google Scholar
  24. 24.
    Millar-Craig MW, Bishop CN, Raftery EB. Circadian variation of blood-pressure.Lancet 1978;5:795–797.Google Scholar
  25. 25.
    Berglund GB, De Faire U, Castenfors J, et al. Monitoring 24-hour blood pressure in a drug trial. Evaluation of a noninvasive device.Hypertension 1985;7:688–694.PubMedGoogle Scholar
  26. 26.
    Hansson BG, Lyngstam G, Lyngstam O, et al. Antihypertensive effect of felodipine combined with β-blockade. A comparison between 2 and 3 daily dosages.Drugs 1985;29(Suppl 2):131–136.PubMedGoogle Scholar
  27. 27.
    Vanhees L, Fagard R, Amery A. Effect of verapamil on systemic and brachial artery haemodynamics in normal humans: Comparison with effect of atenolol.J Cardiovasc Pharmacol 1989;14:642–647.PubMedGoogle Scholar
  28. 28.
    Figulla HR, Kreuzer H, Luig M. Verapamil, diltiazem or nifedipine in severe left ventricular functional disorder? A comparative study of the immediate hemodynamic effects.Dtsch Med Wochenschr 1986;111:11–14.PubMedGoogle Scholar
  29. 29.
    Lund-Johansen P, Ornrik P. Central haemodynamic changes of calcium antagonists at rest and during exercise in essential hypertension.J Cardiovasc Pharmacol 1987: 10(Suppl 1):S139-S148.Google Scholar
  30. 30.
    Vinks AATMM, Bruggink TM, Van Brummelen P, et al. Verapamil slow release tablets: Kinetic and dynamic properties in healthy volunteers. In:Hypertension-the next decade. Berlin ICC, 10–11 October 1985, Edinburgh: Churchill Livingstone, 1985:213–217.Google Scholar
  31. 31.
    Kirsten EB, Guerrero J, Müller-Peltzer H. Pharmacokinetics of a verapamil slow release formulation.J Cardiovasc Pharmacol 1987;10(Suppl 1):S274-S279.Google Scholar
  32. 32.
    Fuenmayor NT, Faggin BM, Cubeddu LX. Comparative efficacy, safety and kinetics of immediate- and slow-release verapamil in hispanic patients with essential hypertension.J Cardiovasc Pharmacol 1989;13(Suppl 4P):S53-S56.PubMedGoogle Scholar
  33. 33.
    Jorgensen NP, Walstad RA. Pharmacokinetics of verapamil and norverapamil in patients with hypertension: A comparison of oral conventional and sustained release formulations.Pharmacol Toxicol 1988;63:2:105–107.PubMedGoogle Scholar
  34. 34.
    Zanolla L, Padrini R, Piovan D, et al. Plasma levels of verapamil and its major metabolites during long-term oral treatment, in chronic stable angina. Correlation with the clinical effects of the drug.Cardiologia 1985;30,5:369–373.PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1990

Authors and Affiliations

  • Luigi Corea
    • 1
  • Maurizio Bentivoglio
    • 1
  • Silvano Berioli
    • 1
  • Carlo Bianchini
    • 1
  • Ketty Savino
    • 1
  • Marco Sardina
    • 1
  1. 1.Medical DepartmentCiba-GeigyOriggio (Varese)Italy

Personalised recommendations