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.