An objective comparison of verapamil and placebo in chronic stable angina.
1. The efficacy of verapamil in a dose of 360 mg daily in patients with chronic stable angina pectoris was assessed by quantitative serial treadmill exercise tests and trinitrin consumption. Twenty-eight patients were investigated in a placebo-controlled, double-blind cross-over comparison of 2 weeks each, after which all were put on long-term verapamil treatment. Exercise tests were done at the end of the placebo period and after 2 and 4 weeks on verapamil. 2. On placebo, all twenty-eight patients developed angina during treadmill tests and the mean exercise time was 6.6 min (s.e.m. = 0.5 min). On verapamil, this increased to 9.2 min (s.e.m. = 0.8 min) at 2 weeks and to 11.2 (s.e.m. = 0.8 min) at 4 weeks, respectively. Trinitrin consumption showed a similar improvement. The double product and ST segment changes, analysed by on-line computer, showed a statistically significant improvement. The only side effects were constipation (in seven patients) and reversible PR-interval prolongation (in two patients). There was no clinical evidence of heart failure in any of the patients. 3. These findings suggest that verapamil has a powerful antianginal action and, in a dose of 360 mg daily, may have a place as a primary agent in the management of chronic stable angina.
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000188:drug therapy*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003248:Constipation / Q000139:chemically induced; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000627:therapeutic use; D010919:Placebos / Q000627:therapeutic use*; D014700:Verapamil / Q000009:adverse effects / Q000627:therapeutic use*
D002121:Calcium Channel Blockers; D010919:Placebos; D014700:Verapamil; D005996:Nitroglycerin