Effects of verapamil closely match normal circadian hemodynamic rhythms

מתוך medicontext.co.il
NEW YORK (Reuters Health) – Controlled-onset, extended-release (COER-24) verapamil results in BP and pulse changes that are closer to normal circadian hemodynamic rhythms than that obtained with either enalapril or losartan treatment, according to the results of a clinical trial.

"COER-24 verapamil is a relatively new formulation of an old drug," co-investigator Dr. Paul T. Vaitkus, from the University of Illinois at Chicago, told Reuters Health. COER-24 is specifically formulated to deliver more of the drug in the morning, when BP starts to soar, and to deliver less at night, when BP tends to be low."

"COER-24 verapamil met the normal circadian rhythm in a better fashion than the other medications," he continued.

Dr. Vaitkus' team randomized 406 patients to COER-24 verapamil 240 mg/day, titrated to 360 mg/day; enalapril 10 mg/day, titrated to 20 mg/day, losartan 50 mg/day titrated to 100 mg/day; or placebo, according to the report in the January issue of the American Journal of Hypertension.

Over the 8-week trial, CORE-24 verapamil was more effective in lowering morning BP than either enalapril or losartan.

Over the 24-hour period, COER-24 verapamil and enalapril had similar effects in lowering systolic and diastolic BP. However, losartan was not as effective as COER-24 verapamil in lowering diastolic BP.

Only COER-24 verapamil lowered heart rate over the 24 hours and when patients were awake, Dr. Vaitkus' group notes.

COER-24 verapamil blunted the rise in BP after awaking, which was not seen with losartan, enalapril or placebo. COER-24 verapamil and losartan had similar effects in reducing nighttime BP. However, enalapril reduced nighttime systolic BP more than the other medications, the investigators note.

"Verapamil, even though it is an old drug, is effective for treating BP and lowering the heart rate," Dr. Vaitkus said. "Sometimes in the search for better, newer therapies we overlook…effective treatment options."

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