Verapamil SR/trandolapril combination therapy for the elderly hypertensive patient

Holzgreve, Heinrich; Compagnone, Daniele; Zilles, Peter

doi:10.1038/sj.jhh.1000728

Cited by 8 publications

(7 citation statements)

References 15 publications

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“…At the last individual visit during active treatment (also taking the non-responders into account) the mean reduction of blood pressure was 21.9/17.1 mmHg (95% CI 19.8 -24.1/16.1 -18.1 mmHg), with most of this reduction occurring during the first 3 months of treatment. After 6 months, 81.9% of the patients enrolled showed normalisation of diastolic blood pressure (< 90 mmHg) and 85% were responders [62]. The normalisation and responder rates appeared to be comparable when stratified by age groups (63 -69, 70 -79, ≥ 80 years) and were all > 80% [62].…”

Section: Treatment Of the Elderly Hypertensivementioning

confidence: 92%

“…After 6 months, 81.9% of the patients enrolled showed normalisation of diastolic blood pressure (< 90 mmHg) and 85% were responders [62]. The normalisation and responder rates appeared to be comparable when stratified by age groups (63 -69, 70 -79, ≥ 80 years) and were all > 80% [62].…”

Section: Treatment Of the Elderly Hypertensivementioning

confidence: 92%

“…A total of 254 elderly hypertensive patients (71 men and 183 women) aged 63 -92 years, with a diastolic blood pressure of 95 -115 mmHg (at the end of a 4-week single-blind placebo run-in period) were treated in an open, non-comparative, multicentre study by a fixed combination of verapamil SR/trandolapril [62]. The treatment started at step 1 by verapamil SR/trandolapril 120/0.5 mg o.d., if diastolic blood pressure was not normalised (< 90 mmHg) at 4 weeks, step 2 was used with verapamil SR/trandolapril 180/1 mg o.d., and if the diastolic blood pressure was not normalised at 8 weeks, step 3 was institutedcombination therapy with verapamil SR/trandolapril 180/2 mg.…”

Section: Treatment Of the Elderly Hypertensivementioning

confidence: 99%

“…Therefore, the data from the German VeraTran Hypertension Study Group [62] in 254 elderly hypertensive subjects treated by a combination of verapamil SR/trandolapril for 6 months are of great interest. 21 patients were withdrawn from the study due to adverse events during the treatment period.…”

Section: Safetymentioning

confidence: 99%

“…They mostly included abdominal pain and other intestinal complaints (4), cough (3), chest pain (2), headache (2) and hypertension (2 ), palpitation (1) and hot flushes (1). 6 patients developed serious adverse events (hospitalisation due to a joint disorder, acute deterioration of kidney function, rash, hypertensive crisis, cerebral ischaemia, worsening of known bladder neoplasms) [62]. Only 8 out of these 21 adverse events were considered by the study physician to be causally related to the study treatment and only 1 of these was considered serious (rash covering the whole body) [62].…”

Section: Safetymentioning

confidence: 99%

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The fixed combination of verapamil SR/trandolapril

Widimský

2000

Expert Opinion on Pharmacotherapy

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Fixed verapamil SR/trandolapril combinations 180/1 mg and 180/2 mg (Tarka, Knoll AG) have a significantly superior antihypertensive effect compared to equal dosages of either agent alone. Verapamil SR/trandolapril 180/2 mg combination produces the best dose-response ratio of different dose combinations of these two drugs. Combination therapy has the most pronounced effect on blunting the early morning rise in blood pressure. Thus, verapamil SR/trandolapril combination therapy may be an appropriate treatment option in patients with moderate essential hypertension, particularly in those who have a tendency toward the early morning rise in blood pressure. The adverse effect profile of the fixed combination of verapamil SR/trandolapril includes the typical side effects of its monocompounds. The fixed combination of verapamil SR/trandolapril is also effective and safe in the treatment of hypertension in the elderly. The fixed low-dose combination therapy with verapamil SR/trandolapril 180/2 mg is a suitable treatment option for patients with moderate essential hypertension and Type 2 diabetes mellitus, because it improves parameters of carbohydrate metabolism and uricaemia and does not alter the lipid profile. The insulin-sensitising effect of angiotensin converting enzyme (ACE) inhibitor monotherapy with its theoretical risk of hypoglycaemia is completely neutralised in the combination with verapamil SR. Comparative studies have shown that the low-dose combination of verapamil SR/trandolapril may be a suitable alternative to combinations containing a thiazide diuretic or a beta-blocking agent for the long-term management of hypertensive patients for whom combination therapy is indicated. The combination of an ACE inhibitor with a non-dihydropyridine calcium channel blocker reduces proteinuria to a greater extent than either agent alone. A combination of an ACE inhibitor and a calcium channel blocker may provide additional benefit in inducing the regression of left ventricular hypertrophy. Combination therapy leads to a significant increase in left ventricular ejection fraction, improvement of wall motion index and increases exercise duration time in patients with coronary heart disease and left heart failure. It also improves the ratio of exercise to rest rate-pressure product and decreases the number of angina attacks. These findings support the hypothesis that the combination of verapamil and trandolapril might be useful in patients with attenuated left ventricular function and angina pectoris. Thus, Tarka is an effective and well-tolerated antihypertensive agent with a good safety profile and positive metabolic effects.

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Section: Treatment Of the Elderly Hypertensivementioning

confidence: 92%

Section: Treatment Of the Elderly Hypertensivementioning

confidence: 92%

Section: Treatment Of the Elderly Hypertensivementioning

confidence: 99%

Section: Safetymentioning

confidence: 99%

Section: Safetymentioning

confidence: 99%

See 3 more Smart Citations