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Verapamil SR Has More Favorable Impact on Mood Than Atenolol in Hypertensive Patients: Presented at ASH(HYP)

By Jill Stein

NEW YORK, NY -- May 25, 2004 -- A verapamil SR-based strategy should be considered an alternative to beta blockers for the treatment of hypertension in coronary artery disease patients, particularly in those who are at risk of depression, researchers recommended here on May 21^st at the American Society of Hypertension Nineteenth Annual Scientific Meeting.

The recommendation is based on the findings of a study which showed that depressive symptoms improved after 1 year of treatment with a verapamil SR-based strategy but did not change with an atenolol strategy.

To determine whether treatment with verapamil SR or atenolol was a significant predictor of major depressive events, L. Douglas Ried, PhD, Associate Professor, Department of Pharmacy Health Care Administration, University of Florida, Gainesville, and colleagues compared the level of depressive symptoms among 1100 patients in the INternational VErapamil SR/trandolapril STudy (INVEST).

"Depression has been reported to occur in patients receiving antihypertensive therapies, particularly those using beta blockers," Dr. Ried commented. "However, data supporting an association between these agents and an increased risk for depression are limited and conflicting."

Given the equal clinical effectiveness of beta blockers and calcium channel blockers, the impact of alternative hypertension treatment strategies on patients' mood is an important topic to address, he said.

Dr. Ried's team analysed the results of health-related surveys completed by about 1,100 patients who had been enrolled in INVEST. The surveys, which included measures of depressive symptoms, were completed within 24 hours of randomization and a year later.

There were no significant differences in baseline characteristics between treatment groups, including depressive symptoms, prior depression, and prior hypertension treatment. In addition, blood pressure control was similar between treatment groups at baseline and at 1 year.

Patients in the verapamil SR group improved an average of 1.45 points (P <.001) on the Center for Epidemiological Studies-Depression (CES-D) scale from randomization to follow-up, whereas improvement was negligible (0.25 points) in patients assigned to the atenolol group (P =.48). Depressive symptoms in patients in the atenolol group were more likely to worsen by at least 5 points (27% versus 18%; P =.03).

The study also identified history of stroke, depression at baseline, and prior diagnosis of depression as significant predictors of depressive symptoms at 1 year.

The University of Florida and Abbott Laboratories provided funding for the study.


[Presentation title: "Depressive symptoms among hypertensive patients treated with verapamil SR-led versus atenolol-led treatment strategies." Poster #P245]

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