A Comparison of Controlled Release Antihypertensives Verapamil appears better tolerated than propranolol

A double-blind study was conducted to compare the efficacy and tolerability of a new sustained release formulation of verapamil CSecuron SR') and controlled release propranolol Clnderal LA') in patients with mild to moderate hypertension. Following a 1-week washout and 3-week placebo run-in, 97 patients from 3 general practices received verapamil 240-480mg daily (n = 46) or propranolol 160-320mg daily (51). Doses were titrated at monthly intervals to achieve a diastolic BP ~ 90mm Hg or a reduction of ~ 15mm Hg.

After 1 month's treatment, BP fell significantly in both groups; 59% of verapamil and 63% of propranolol recipients had achieved goal BP. After 4 months' treatment (n = 82), mean BP was reduced by 18/16mm Hg and 21/15mm Hg, respectively. Target BP was achieved by 88% of patients in each group who completed the study. 67% of patients had their BP controlled on the lowest dose of verapamil and 64% on the lowest propranolol dose. Heart rate was significantly reduced in propranolol recipients at all visits . Two verapamil vs 10 propranolol recipients (p < 0.05) withdrew because of adverse effects. 19 verapamil-treated patients reported 29 adverse events compared with 39 reactions reported by 24 propranolol recipients.

The results indicate that sustained release verapamil and long acting propranolol have a similar BP lowering effect but verapamil '. , . is better tolerated and represents a rational alternative first line antihypertensive therapy in general practice', Bochsler JA. Simmons RL. Ward PJ. Chester PC, Latham AN Journal of Human Hypertension 1 305·310, Mar 1988 .. "

14 INPHARMA' 7 May 1988 0156-2703/ 88/ 0507·0014/ 0S01 .00/ 0 © AD/S Press