Another Hypertension Trial: Verapamil vs. Hydrochlorothiazide or Atenolol

Therapy with a calcium-channel blocker, a diuretic, or a β-blocker yielded similar outcomes. But was it appropriate to stop the trial early?

Results from the ALLHAT study reinforced the idea that diuretics should remain the standard of comparison for initial antihypertensive therapy (Journal Watch Jan 14 2003). Now, investigators report results from an industry-sponsored, multicenter, randomized trial (the CONVINCE trial) in which a controlled-onset, extended-release form of the calcium-channel blocker verapamil was examined.

More than 16,000 patients with hypertension and 1 or more additional cardiac risk factors were enrolled. Half received verapamil (180 mg daily); the rest received either hydrochlorothiazide (12.5 mg daily) or atenolol (50 mg daily), according to the investigators' judgment of which would be best for each patient. An algorithm dictated dose changes and additi…

Reviewing Author

Allan S. Brett, MD