ISSN:
1573-7241
Keywords:
atenolol
;
slow-release nifedipine
;
chronic stable angina
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Summary There is still uncertainty of whether combined therapy with a beta-blocker and calcium-channel antagonist provides additive or synergistic clinical benefits in most patients with stable angina pectoris. The comparative antianginal effect of atenolol 50 mg and atenolol 50 mg and slow-release nifedipine (20 mg) twice a day was assessed in 27 patients with chronic stable angina in a randomized, double-blind, crossover study. After a 4 week run-in period on atenolol, patients were randomly allocated to receiveeither atenolol aloneor its combination with nifedipine and then crossed over to the alternative treatment for a further 4 weeks. Symptom-limited exercise treadmill tests were performed according to the Naughton protocol. The major endpoints in this study were (a) exercise time to pain; (b) exercise time to ≥1 mm ST depression; (c) total exercise time; (d) maximal ST-segment depression; (e) number of anginal attacks; and (f) nitrate consumption. The preexercise systolic blood pressure was lower on the combination treatment than on atenolol alone, but heart rate was lower on atenolol compared with the combination treatment. There was no difference in the systolic blood pressure at the onset of pain or at 1 mm ST depression, while heart rate was lower on both occasions with atenolol compared to the combination treatment. There was no difference between the two treatments in terms of the rate-pressure product at the onset of pain or at 1 mm ST depression. Twice as many patients experienced pain later with the combination treatment than with atenolol alone. There was no difference for the time without ST segment depression, maximal exercise time, number of anginal attacks, nitrate consumption, and side effects between the treatments. These data suggest that, apart from the time of onset of mild pain, the combination treatment of slow release nifedipine (20 mg) and atenolol (50 mg) twice a day is no better than atenolol alone in patients with stable angina pectoris. It is uncertain whether a higher titrated dose of nifedipine combined with atenolol would have produced the same results.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00877726
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