title: Antianginal response to once-daily diltiazem CD in patients receiving concomitant beta-blockers, long-acting nitrates, or both. Diltiazem CD Study Group.
abstract: OBJECTIVE
  To determine the safety and efficacy of diltiazem CD 180 mg administered once/day in patients with chronic stable angina inadequately controlled with P-blockers, long-acting nitrates, or both.
  
  
  METHODS
  Multicenter, randomized, double-blind, placebo-controlled, parallel-group trial.
  
  
  METHODS
  Medical clinics in the private and academic sectors.
  
  
  METHODS
  Of 172 patients, 170 completed the 2-week double-blind treatment period.
  
  
  METHODS
  . Patients received either diltiazem CD 180 mg or placebo once/day in combination with existing antianginal therapy.
  
  
  RESULTS
  The time to termination of exercise tolerance testing, 24 hours after the dose increased significantly in the diltiazem CD group (37.2 sec) compared with the placebo group (21.3 sec, p=0.0438). Time to onset of angina during exercise testing also increased (57.6 vs 35.0 sec, respectively, p=0.0324), as did time to moderate angina (37.5 vs 20.6 sec, respectively, p=0.0354). The rates of total angina attacks and of angina attacks on exertion were significantly reduced in the diltiazem CD group versus placebo (p<0.05). Significant reductions in systolic and diastolic blood pressures and heart rate-blood pressure product measured at rest, submaximum exercise, and exercise termination were observed in diltiazem CD-treated patients compared with placebo (p<0.05). The frequency of treatment-related adverse events was identical in the two groups, 15.1%.
  
  
  CONCLUSIONS
  Diltiazem CD 180 mg once/day is an effective, safe, and beneficial initial dosage when added to existing antianginal therapy.
authors.affiliation: Division of Cardiology, Hartford Hospital, Connecticut 06102, USA.
authors.forename: G V
authors.initials: GV
authors.lastname: Heller
authors.forename: M
authors.initials: M
authors.lastname: Sridharan
authors.forename: J
authors.initials: J
authors.lastname: Morse
authors.forename: S
authors.initials: S
authors.lastname: Glasser
authors.forename: C L
authors.initials: CL
authors.lastname: Beach
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy*; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D003692:Delayed-Action Preparations; D004110:Diltiazem / Q000008:administration & dosage*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D003692:Delayed-Action Preparations; D009566:Nitrates; D014665:Vasodilator Agents; D004110:Diltiazem