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Ketanserin is a new potent antiserotonergic drug which, unlike previous ones, is selective for S2-serotoninergic receptors and does not have an agonist action. A trial was carried out on medium-term treatment with ketanserin or propranolol in subjects suffering from mild to moderate hypertension. The trial was designed as a double-blind crossover randomized study comparing either ketanserin or propranolol with placebo. Thirteen patients completed the study, which was divided into two groups (A and B). Systolic (SBP), diastolic (DBP) and mean (MBP) blood pressures were measured by non-invasive, intermittent ambulatory monitoring performed using a Pressurometer II, from Del Mar Avionics. Heart rate was measured using a continuous electrocardiogram monitoring. Systolic blood pressure was significantly reduced both after ketanserin (A:11.1%; B:10.8%) and propranolol (A:11.7%; B:11.8%) but in group A its decrease was more pronounced after propranolol (P less than 0.01). Diastolic blood pressure was significantly reduced both after ketanserin (A:11.5%; B:11.1%) and propranolol (A:11.4%; B:11.9%), as was MBP (A:11.9%; B:11.8% for ketanserin and A:11.9%; B:11.9% for propranolol). The heart rate diminished significantly only after propranolol administration (P less than 0.01). Ambulatory monitoring showed a significant 24-h reduction of SBP after administration of propranolol (P less than 0.0025) and ketanserin (A:P less than 0.0025, B: P less than 0.005). Diastolic blood pressure was also significantly reduced after ketanserin (P less than 0.0005) and propranolol (A: P less than 0.0025, B: P less than 0.0005). The heart rate obtained by continuous electrocardiogram monitoring diminished significantly only after propranolol administration (P less than 0.0005). No significant changes of circadian behaviour of blood pressure were observed.

The aim of our study was to evaluate the antihypertensive effectiveness of verapamil slow-release (SR), administered once a day. We studied 11 patients, 7 male and 4 female, with an average age of 53.6 +/- 12.86 years, who had essential hypertension. After a drug washout period of at least 15 days, placebo was administered (one tablet per day), and then patients received verapamil SR 240 mg/day at 8:00 a.m. for at least 2 weeks. At the end of the washout, placebo, and active drug treatment periods we performed ambulatory intermittent blood pressure monitoring for 24 h using a Squibb Spacelabs pressurometer. After verapamil treatment, in comparison to placebo, a significant reduction of systolic (SBP) and diastolic blood pressure (DBP) (154.91 +/- 13.34/94.29 +/- 9.48 vs. 143.73 +/- 11.39/84.6 +/- 7.99 mm Hg; p less than 0.005), was observed without significant changes of the circadian blood pressure pattern. Moreover, we observed a significant reduction of SBP and DBP variability mainly during daytime, whereas this behavior was not evident for heart rate. In conclusion, verapamil SR seems useful to obtain a constant and significant reduction of 24-h blood pressure values with a significant reduction of SBP and DBP variability.