ISSN:
1573-7241
Keywords:
angina pectoris
;
systemic hypertension
;
nicardipine
;
nifedipine
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Summary The two dihydropyridine calcium antagonists, nicardipine and nifedipine, were compared in 12 patients with both stable angina pectoris and systemic hypertension using a double-blind, crossover protocol. After a 2-week placebo run-in period, each patient was randomized to either nicardipine or nifedipine; each drug was titrated up to either blood pressure normalization, appearance of adverse effects, or maximal dosage (40 mg, three times a day with nicardipine and 30 mg, three times a day with nifedipine) and then administered for 4 weeks. Maximal symptom-limited exercise tests were performed at the end of the placebo run-in and each treatment period, 3 and 8 hours after drug administration. Nicardipine and nifedipine were used at the mean doses of 100±20 mg/day and 57±20 mg/day, respectively. Both drugs reduced, significantly and similarly, standing and supine blood pressure, frequency of anginal episodes, and nitroglycerin consumption. At 3 hours after drug administration, exercise duration and time to 1-mm ST depression increased significantly from 402±84 and 306±108 seconds, respectively, with placebo; to 533±135 and 442±138 seconds during nicardipine; and to 518±118 and 437±133 seconds during nifedipine, with a concomitant reduction of peak ST depression. Both submaximal and maximal exercise diastolic blood pressure were significantly reduced by the two calcium antagonists whereas systolic blood pressure was decreased only at submaximal but not at maximal exercise; the heart rate was not significantly modified by the two drugs at any exercise stage. The rate-pressure product decreased from 169±17 to 151±25 with nicardipine and 152±24 with nifedipine at submaximal exercise, but was not significantly modified at the onset of 1-mm ST depression and maximal exercise. Thus, nicardipine and nifedipine showed a similar hypotensive and antianginal activity; the only important difference between the two drugs emerged from the exercise tests performed 8 hours after drug administration; although nifedipine still maintained a slight antianginal activity, nicardipine showed a significantly greater anti-ischemic and hemodynamic activity at that time.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF02125734
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