Antianginal and Exercise Tolerance Efficacies of Nifedipine, Diltiazem and Their Combination in Chronic Stable Angina
Material and Method
The antianginal efficacies of oral Nifedipine (N) (30 to 100 mg/day), Diltiazem
(D) (120 to 320 mg/day) and their combination (N + D, 30 to 60 + 90 to 270) were
compared in 24 normotensive patients with chronic stable angina, using
randomised, double-blind titration to achieve maximal effec
|
Placebo |
N |
Placebo |
D |
Placebo |
N + D |
|
|
WEEKS |
1 - 2 |
4 to 6 |
1 to 2 |
4 - 6 |
1 - 2 |
4 - 6 |
We studied effects of placebo, N, D and the combination
of N and D on frequency of angina attack, NGL consumption, resting pulse and BP,
exercise tolerance (exercise duration, time to pain onset, value of ST
depression). Plasma drug levels were measured in 6 patients.
Results
Compared with initial placebo values, the frequency of angina and consumption of
NGL were reduced both by D (p<0.001) and N (p<0.02). Duration of symptom-limited
treadmill exercise was for N 540 ± 34 sec, for D 320 ± 42 sec, for N+D 620 ± 52
sec, and with placebo baseline 450 ± 39 sec.
Conclusion
D was more effective than N in reducing angina (p<0.02). D significantly reduced
ST segment depression, resting heart rate and resting blood pressure (p<0.01).
The maximum tolerated dose for N was 70 ± 29 mg/day and for D 240 ± 25.4 mg/day.
This investigation demonstrated that utilisation of high dose of D (more than
240 mg/day) increased incidence of a-v block and peripheral vasodilatory
effects. In contrast, N with dose more than 70 mg/day is not associated with A-V
block but a clinically high dosage levels the incidence of peripheral edema.
Z. STAMENKOVIC, MD University Clinic of Cardiology,
Institute of Cardiovascular Diseases; Novi Sad, Yugoslavia
N. DRAGANIC, MD University Clinic of Cardiology, Institute of Cardiovascular
Diseases; Novi Sad, Yugoslavia
M. DRAGANIC-CECILIO University of Novi Sad, Medical Faculty; Novi Sad,
Yugoslavia (Medical Student, year IV)
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