Effects of antihypertensive drugs on SBP variability are dose-dependent and persist when used in combinations .
Use of a high dose of a calcium channel blocker alone or in combination with other agents is therefore likely to be particularly effective in prevention of stroke
BACKGROUND AND PURPOSE Recent studies have shown that visit-to-visit blood pressure variability is a powerful risk factor for stroke , is reduced by calcium channel blockers and diuretics , and increased by β-blockers .
However , it is unknown whether these effects are dose-dependent and persist in combination with other drugs .
Effect of verapamil, trandolapril and their combination on vascular function and structure in essential hypertensive patients.
AIM The aim of the present study is to evaluate the effect of treatment with verapamil , tr and olapril and their combination on peripheral microcirculation vasoreactivity . METHODS Twenty hypertensive patients were r and omized to receive oral tr and olapril ( 4 mg oid ; TRA ) or verapamil ( 240 mg oid ; VER ) for 6 months and then the combination of the two drugs for additional 6 months . At baseline , 6 months and 12 months , peripheral microcirculation vasoreactivity was evaluated by forearm blood flow technique ( venous plethysmography ) , as vasodilation to an endothelium-dependent ( acetylcholine ) and an endothelium-independent stimulus ( sodium nitroprusside , SNP ) ; minimal forearm vascular resistances ( MFVR ) were also evaluated . RESULTS Blood pressure decreased similarly and progressively in both groups throughout the study period . In VER , 6-month verapamil treatment significantly increased vasodilation to acetylcholine , but not to SNP . The superimposition of tr and olapril increased the response to SNP , and less to acetylcholine . In TRA group , 6-month treatment with tr and olapril improved the response to SNP , but not to acetylcholine . In this group , the superimposition of verapamil caused a significant improvement in the response to acetylcholine , but not to SNP . At the end of the study , MFVR were significantly reduced in both groups , but to a greater extent in TRA . CONCLUSION The present study demonstrates that chronic treatment with verapamil ameliorates endothelial function in the forearm microcirculation of essential hypertensive patients , while tr and olapril protects microcirculation from structural alterations . The combination of the two drugs is potentially a powerful tool to counteract hypertension-related microvascular dysfunction and damage
Effects of antihypertensive drugs on SBP variability are dose-dependent and persist when used in combinations .
Use of a high dose of a calcium channel blocker alone or in combination with other agents is therefore likely to be particularly effective in prevention of stroke
BACKGROUND AND PURPOSE Recent studies have shown that visit-to-visit blood pressure variability is a powerful risk factor for stroke , is reduced by calcium channel blockers and diuretics , and increased by β-blockers .
However , it is unknown whether these effects are dose-dependent and persist in combination with other drugs .