[The calcium antagonists diltiazem and nifedipine: a comparison of their efficacy in single and long-term use in patients with stable stenocardia of effort].
OBJECTIVE
To compare efficacy of diltiazem and nifedipine in single dose and long-term treatment.


METHODS
A randomised double-blind cross-over study enrolled 17 patients suffering from coronary heart disease (CHD) with stable angina of effort (SAE). For 1 month, each patient received diltiazem and nifedipine (60-90 mg 4 times a day and 20-30 mg 4 times a day, respectively). The effect was assessed by the pharmacodynamic test after the initial dose and in the end of each treatment course.


RESULTS
In 14 eligible patients both drugs reduced the number of SAE attacks and nitroglycerin tablets, diltiazem efficiency being somewhat higher. Single doses of diltiazem and nifedipine produced the same action. In long-term treatment nifedipine effect became shorter, diltiazem effect did not change. Before the morning dose of nifedipine (11.5 hours after the previous dose) exercise tolerance of this drug worsened. This may be due to withdrawal syndrome. As to diltiazem, its exercise tolerance improved.


CONCLUSIONS
In long-term treatment of CHD with SAE diltiasem is more effective and safe than nifedipine.
S Iu
SIu
Martsevich
P P
PP
Kutishenko
E V
EV
Alimova
I D
ID
Slastnikova
V I
VI
Metelitsa
D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000188:drug therapy*; D002121:Calcium Channel Blockers / Q000008:administration & dosage* / Q000009:adverse effects; D002908:Chronic Disease; D004110:Diltiazem / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004361:Drug Tolerance; D005080:Exercise Test; D006801:Humans; D008875:Middle Aged; D009543:Nifedipine / Q000008:administration & dosage* / Q000009:adverse effects; D005082:Physical Exertion; D013997:Time Factors
D002121:Calcium Channel Blockers; D004110:Diltiazem; D009543:Nifedipine
Antagonisty kal'tsiia diltiazem i nifedipin: sravnenie éffektivnosti pri odnokratnom i dlitel'nom primenenii u bol'nykh stabil'noĭ stenokardieĭ napriazheniia.