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European Heart Journal 1992 13(2):256-260;
Copyright © 1992 by the European Society of Cardiology.
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© 1992 The European Society of Cardiology

Sustained-release verapamil and nifedipine in exercise-induced angina pectoris

R. A. FOALE*, and M. J. VANDENBURG{dagger}

*Cardiology Department, St Mary's Hospital London W2 INY
{dagger}Cardiology Department, Oldchurch Hospital Romford, Essex, U.K.

Received 14 February 1990; revised 4 October 1990; .

Correspondence. Dr R. A. Foale. Cardiology Department. St Mary's Hospital. London W2 1NY.U K

Abstract

In a randomised, double-blind, crossover study of oral sustained-release verapamil 360 mg o.d. (‘SR-verapamil’) and oral nifedipine 20mg t.d.s. in 19 patients with chronic stable angina pectoris, significantly greater improvement from baseline was seen with SR-verapamil than with nifedipine. Mean exercise duration was 380 ± 108s with SR-verapamil and 343 ± 130s with nfedipine (P <0.05); mean time to onset of angina was 326 ± 79s with SR-verapamil and 239 ± 79s with nifedipine (P <0.01); median time to 1 mm ST depression was 252s (range 114–579) with SR-verapamil and 182 s (range 84–582) with nifedipine (P <0.01); mean ST depression at maximum exercise was 1.65 ± 0.56mm with SR-verapamil and 2.17± 0.98 mm with nifedipine (P <0.05). Ambulatory ECG recordings indicated a trend in favour of SR-verapamil (median ST-time integral 0.00 [range 0–24.16] mm h–1 with SR-verapamil, 1.15 [range 0–12.50] mm h–1 with nifedipine, not significant). Median glyceryl trinitrate consumption was signficantly lower (P < 0.05) with SR-verapamil (0.21; range 0–1.25 per day) than with nifedipine (0.31; range 0–1.32 per day), but there was no significant difference between angina attack frequency. Adverse events were reported by two patients with SR-verapamil and nine with nifedipine. Once-daily sustained-release verapamil 360 mg has a significantly better effect on exercise tolerance than nifedipine 20 mg t.d.s. and also appears to be better-tolerated.

Key Words: Verapamil • sustained-relese • nifedipine • angina pectoris


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