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Antihypertensive response to verapamil modulated by age, gender

NEW YORK (Reuters Health) – Women and older patients experience greater antihypertensive effects from treatment with the controlled-onset, extended-release (COER) formulation of the calcium antagonist verapamil than do men and younger patients.

Dr. William B. White, of the University of Connecticut Health Center, Farmington, and colleagues examined the determinants of the 24-hour antihypertensive response to verapamil in a meta-analysis of three prospective randomized, double-blind, placebo-controlled trials.

As reported in the December issue of the American Journal of Hypertension, the studies included 273 hypertensive patients who were randomized to receive 180 to 540 mg/day of COER-verapamil, and 125 patients were randomized to receive placebo.

Women treated with the COER-verapamil experienced greater reductions in both 24-hour systolic and diastolic blood pressure than men, at -15.1 versus -10.0 mm Hg (p < 0.001) and -10.4 versus -8.2 mm HG (p = 0.003), respectively.

"Older patients showed a greater mean reduction in 24-hour diastolic blood pressure (-10.2 versus -8.2 mm Hg; p < 0.05) and heart rate (-5.7 versus -4.4 beats/min; p < 0.05) compared with younger patients," the authors report. They note that side effects were similar in all patients treated with COER-verapamil.

"Further evaluation of differences in response to treatment between men and women and between older and younger patients may help to identify whether specific antihypertensive regimens may offer therapeutic advantages in these populations," Dr. White and colleagues conclude.

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