Enalapril and verapamil in the treatment of isolated systolic hypertension in the elderly.

A prospective, investigator-blinded, randomized study was conducted to compare the efficacy and tolerability of enalapril and verapamil in the treatment of isolated systolic hypertension in elderly patients. Of the 115 patients who completed the study, 58 received enalapril and 57 verapamil. The goal of treatment was a systolic blood pressure < 160 mmHg and a reduction of at least 20 mmHg below baseline. The initial daily dose of enalapril was 5 mg, and of verapamil 240 mg. The dosage was titrated upward until the goal blood pressure was achieved. At the end of the titration period, systolic and diastolic blood pressures were significantly decreased (P < 0.001) in both patient groups. Blood pressure remained significantly decreased (P < 0.001) in both groups during the 8-week maintenance treatment period. There were no significant differences between groups. Two patients in the enalapril group and nine patients in the verapamil group were withdrawn from the study because of adverse effects. The results of this study demonstrate that enalapril and verapamil are well tolerated and effective in the treatment of isolated systolic hypertension in the elderly.