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Effects of Treatment with Verapamil SR and Captopril on the Lipid Profile of Hypertensive Patients

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Summary

The potential beneficial effects of antihypertensive drugs on cardiovascular morbidity and mortality may be compromised by their adverse effects on serum lipid levels. In our study we compared verapamil and captopril and evaluated their effects on blood pressure and on serum lipid and lipoprotein levels, with particular attention to lipoprotein(a) [Lp(a)].

20 hypertensive patients were treated with sustained release verapamil 240mg once daily or captopril 25mg twice daily for 3 months in a double-blind randomised study. Diastolic blood pressure was reduced from 100 ± 3mm Hg to 87 ± 6mm Hg (p < 0.01) and from 100 ± 5mm Hg to 92 ± 7mm Hg (p < 0.05) in the verapamil and captopril groups, respectively. Small but significant changes in serum lipid levels were noted: total cholesterol was reduced from 6 to 5.8 mmol/L (verapamil) and from 6.1 to 5.9 mmol/L (captopril); low density lipoprotein (LDL) cholesterol was reduced from 4 to 3.8 mmol/L (verapamil) and from 4.2 to 3.9 mmol/L (captopril); apolipoprotein C-III was reduced from 0.3 ± 0.07 to 0.2 ± 0.06 mmol/L (9.7 ± 2.5 to 9.2 ± 2.3 mg/dl) [verapamil] and from 0.2 ± 0.1 to 0.2 ± 0.09 mmol/L (9.1 ± 3.7 to 8.3 ±3.4 mg/dl) [captopril]; apolipoprotein A-II increased only with verapamil (p < 0.02). Lp(a) levels showed only minor changes in individual patients.

In conclusion, in our study verapamil and captopril were effective antihypertensive agents and did not adversely effect the lipid profile.

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References

  • Alderman MH, Madhavan S, Stanback ME, Davis TK. Relation of blood pressure response to therapy and the occurrence of myocardial infarction and stroke. Journal of Cardiovascular Pharmacology 4: 251–256, 1982

    Article  Google Scholar 

  • Amery A, Birkenhager W, Brixko P, Bulpitt C, Clement D, et al. Mortality and morbidity results from the European Working Party on High Blood Pressure in the Elderly Trial. Lancet 1: 1349–1354, 1985

    Article  PubMed  CAS  Google Scholar 

  • Australian Therapeutic Trial in Mild Hypertension Management Committee. Australian Therapeutic Trial in Mild Hypertension. Lancet 1: 261–267, 1980

    Google Scholar 

  • Black DG, Heagerty AM, Bing RF, Thurston H, Swales JD. Effects of treatment for hypertension on cerebral haemorrhage and infarction. British Medical Journal 289: 156–159, 1984

    Article  PubMed  CAS  Google Scholar 

  • Brunner HR, Gavras H, Waeber B, Kershaw GR, Turini GA, et al. Oral angiotensin-converting enzyme inhibitor in long-term treatment of hypertensive patients. Annals of Internal Medicine 90: 19–23, 1979

    PubMed  CAS  Google Scholar 

  • Frohlich ED, Cooper RA, Lewis EJ. Review of the overall experience of captopril in hypertension. Archives of Internal Medicine 144: 1441–1444, 1984

    Article  PubMed  CAS  Google Scholar 

  • Grimm Jr RH. The drug treatment of mild hypertension in the Multiple Risk Factor Intervention Trial: a review. Drugs 31(Suppl. 1): 13–21, 1986

    Article  PubMed  Google Scholar 

  • Helgeland A. Treatment of mild hypertension: a five year controlled drug trial: the Oslo Study. American Journal of Medicine 69: 725–732, 1980

    Article  PubMed  CAS  Google Scholar 

  • Hostmark AT, Osland A, Simonsen S, Levorstad K. Lipoprotein-related coronary risk factors in patients with angiographically defined coronary artery disease: relation to a number of stenosed arteries. Journal of Internal Medicine 228: 317–321, 1990

    Article  PubMed  CAS  Google Scholar 

  • Hypertension Detection and Follow-up Program Cooperative Group. Five-years findings of the Hypertension Detection and Follow-up Program. Journal of the American Medical Association 242: 2562–2571, 1979

    Article  Google Scholar 

  • Jenkins AC, Dreslinski GR, Tadros SS, Groel JT, Fand R, et al. Captopril in hypertension: seven years later. Journal of Cardiovascular Pharmacology 7(Suppl. 1): S96–S101, 1985

    Article  PubMed  Google Scholar 

  • Johns DW, Baker KM, Ayers CR, Vaughan ED, Carey RM, et al. Acute and chronic effect of captopril in hypertensive patients. Hypertension 2: 567–575, 1980

    Article  PubMed  CAS  Google Scholar 

  • Kanneil WB, Castelli WP, Gordon T, Mcnamara P. Serum cholesterol, lipoproteins and the risk of coronary heart disease. The Framingham study. Annals of Internal Medicine 74: 1–12, 1971

    Google Scholar 

  • Kannel WB, Neaton JD, Wentworth MD, Thomas HE, Stamler J, et al. Overall and coronary heart disease mortality rates in relation to major risk factor in 325, 348 men screened for the MRFIT. American Heart Journal 112: 825–836, 1986

    Article  PubMed  CAS  Google Scholar 

  • Kottke BA, Zinsmeister AR, Holmes Jr DR, Kneller RW, Hallaway BJ, et al. Apolipoproteins and coronary artery disease. Mayo Clinic Proceedings 61: 313–320, 1986

    PubMed  CAS  Google Scholar 

  • Krempler F, Kostner GM, Roscher A, Haslauer F, Bolzano K, et al. Studies on the role of specific cell surface receptors in the removal of lipoprotein (a) in man. Journal of Clinical Investigation 71: 1431–1441, 1983

    Article  PubMed  CAS  Google Scholar 

  • Krone W, Naegele H. Effects of antihypertensives on plasma lipids and lipoprotein metabolism. American Heart Journal 116: 1729–1734, 1988

    Article  PubMed  CAS  Google Scholar 

  • Leren P. Effects of antihypertensive drugs on lipid metabolism. Clinical Therapeutics 9: 326–332, 1987

    PubMed  CAS  Google Scholar 

  • Lewis GR. Long term results with verapamil in essential hypertension and its influence on serum lipids. American Journal of Cardiology 57: 35D–38D, 1986

    Article  PubMed  CAS  Google Scholar 

  • MacMahon SW, Cutler JA, Furberg CD, Payne GH. The effects of drug treatment for hypertension on morbidity and mortality from cardiovascular disease: a review of randomized controlled trials. Progress in Cardiovascular Diseases 29(Suppl. 1): 99–118, 1986

    Article  PubMed  CAS  Google Scholar 

  • Medical Research Council Working Party on Mild to Moderate Hypertension. Adverse reactions to bendrofluazide and propanolol for the treatment of mild hypertension. Lancet 2: 539–543, 1981

    Google Scholar 

  • Medical Research Council Working Party. MRC trial of treatment of mild hypertension: principal results. British Medical Journal 291: 97–104, 1985

    Article  Google Scholar 

  • Midtbo K, Lauve O, Hals O. No metabolic effects of long term treatment with verapamil in hypertension. Angiology 39: 1025–1029, 1988

    Article  PubMed  CAS  Google Scholar 

  • Miettinen TA, Huttunen JK, Naukkarinen V, Stranberg T, Mattila S, et al. Multifactorial primary prevention of cardiovascular disease in middle-aged men. Risk factor incidence and mortality. Journal of the American Medical Association 254: 2097–2102, 1985

    Article  PubMed  CAS  Google Scholar 

  • Multiple Risk Factor Intervention Trial Research Group. Multiple risk factor intervention trial: risk factor changes and mortality results. Journal of the American Medical Association 248: 1465–1477, 1982

    Article  Google Scholar 

  • Paoletti R, Bernini F, Fumagalli R, Allorio M, Corsini A. Calcium antagonists and low density lipoprotein receptors. Annals of the New York Academy of Science 522: 390–398, 1988

    Article  CAS  Google Scholar 

  • Rath M, Niendorf A, Reblin T, Dietal M, Krebber HJ, et al. Detection and quantification of lipoprotein (a) in the arterial wall of 107 coronary bypass patients. Arteriosclerosis 9: 579–592, 1989

    Article  PubMed  CAS  Google Scholar 

  • Riska H, Savijarvi AR, Ahonen A, Salorine Y, Sundberg S, et al. Effects of captopril on blood pressure and respiratory function compared to verapamil in patients with hypertension and asthma. Journal of Cardiovascular Pharmacology 15: 57–61, 1990

    Article  PubMed  CAS  Google Scholar 

  • Samuelsson O, Wilhelmsen L, Andersson OK, Pennert K, Berglund G. Cardiovascular morbidity in relation to change in blood pressure and serum cholesterol levels in treated hypertension. Results from the Primary Intervention trial in Göteborg, Sweden. Journal of the American Medical Association 258: 1768–1776, 1987

    Article  PubMed  CAS  Google Scholar 

  • Sasaki J, Arakawa K. Effect of captopril on high-density lipoprotein subfractions in patients with mild to moderate essential hypertension. Clinical Therapeutics 2: 129–134, 1989

    Google Scholar 

  • Saunders E, Wei MR, Kong BW, Hollifield J, Gray J, et al. A comparison of the efficacy and safety of a beta-blocker, a calcium channel blocker, and a converting enzyme inhibitor in hypertensive blacks. Archives of Internal Medicine 150: 1707–1713, 1980

    Article  Google Scholar 

  • Scanu AM, Fless GM. Lipoprotein (a). Heterogeneity and biological relevance. Journal of Clinical Investigation 85: 1709–1715, 1990

    Article  PubMed  CAS  Google Scholar 

  • Schmieder RE, Messerli FH, Garavaglia GE, Nunez BD. Cardiovascular effects of verapamil in patients with essential hypertension. Circulation 75: 1030–1036, 1987

    Article  PubMed  CAS  Google Scholar 

  • Sedlis SP, Schechtman KB, Ludbrook PA, Sobel BE. Plasma apoproteins and the severity of coronary artery disease. Circulation 73: 978–986, 1986

    Article  PubMed  CAS  Google Scholar 

  • Takiyyuddin MA, Cervenka JH, Dinh T, Witztum JL, O’Connor DT. Selective alpha-blockade versus angiotensin-converting enzyme inhibition as initial antihypertensive therapy. Effects on circulating lipoproteins. American Journal of Medicine 86: 32–35, 1989

    Article  PubMed  CAS  Google Scholar 

  • Veterans Administration Cooperative Study on Antihypertension. Results in patients with diastolic blood pressure averaging 115 through 129mm Hg. Journal of the American Medical Association 202: 1028–1034, 1967

    Article  Google Scholar 

  • Veterans Administration Cooperative Study Group on Antihypertensive Agents. Effects of treatment on morbidity in hypertension II. Results in patients with diastolic blood pressure averaging 90 through 114mm Hg. Journal of the American Medical Association 213: 1143–1152, 1970

    Article  Google Scholar 

  • Weidmann P, Gerber A, Mardasini R. Effects of antihypertensive therapy on serum lipids. Hypertension 5(Suppl. III): 120–131, 1983

    Google Scholar 

  • Wikstrand J, Warnold I, Olsson G, Tuomilehto J, Filmteldo D, et al. Primary prevention with metoprolol in patients with hypertension. Mortality results from the MAPPHY study. Journal of the American Medical Association 259: 1976–1982, 1988

    Article  PubMed  CAS  Google Scholar 

  • Zachariah PK, Sheps SG, Schriger A. Efficacy of sustained-release verapamil: automatic ambulatory blood pressure monitoring. Journal of Clinical Hypertension 3: 133S–142S, 1986

    Google Scholar 

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Authors and Affiliations

  1. Research Centre on Vascular Diseases, Ospedale ‘L. Sacco’, University of Milan, Via G.B. Grossi 74, 20157, Milano, Italy

    Maria Catalano, Carlo Cislaghi, Gianni Carzaniga, Alberto Aronica, Romano Seregni & Arnaldo Libretti

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  1. Maria Catalano
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  2. Carlo Cislaghi
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  3. Gianni Carzaniga
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  4. Alberto Aronica
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  6. Arnaldo Libretti
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Catalano, M., Cislaghi, C., Carzaniga, G. et al. Effects of Treatment with Verapamil SR and Captopril on the Lipid Profile of Hypertensive Patients. Drugs 44 (Suppl 1), 88–93 (1992). https://doi.org/10.2165/00003495-199200441-00016

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