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Blood pressure at rest is not predictive of roundthe- clock values. Blood pressure should therefore be measured during effort to evaluate hypertension and its response to treatment. The effect of sustained-release verapamil (240 mg taken once a day) on blood pressure at rest and during isometric effort was therefore investigated. Overall, verapamil reduced blood pressure significantly in 41 of 45 hypertensive patients: the mean systolic blood pressure at rest (± SD) fell from 151 ± 35 mmHg to 137 ± 13 mmHg (P < 0,001) and the diastolic blood pressure from 97 ± 21 mmHg to 83 ± 7 mmHg (P < 0,001), while the systolic blood pressure during isometric effort fell from 186 ± 23 mmHg to 156 ± 13 mmHg (P < 0,001) and the diastolic blood pressure from 118 ± 14 mmHg to 95 ± 8 mmHg (P < 0,001). The simple, inexpensive handgrip method described is cost-effective and strongly recommended as an integral part of the evaluation of hypertensive patients. The combination of a drug to which compliance is good and a simple method of blood pressure evaluation should result in improved effectiveness of treatment in the long term.