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Br Heart J. 1986 March; 55(3): 240–245. | PMCID: PMC1232159 |
Treatment of angina pectoris with nifedipine and atenolol: efficacy and effect on cardiac function. I N Findlay, K MacLeod, M Ford, G Gillen, A T Elliott, and H J Dargie Abstract The antianginal effects of nifedipine 20 mg three times a day and atenolol 100 mg once a day singly and in combination were investigated in 16 patients with angina pectoris. The amount of work that could be done before angina and ST depression appeared was significantly increased by atenolol and the combination but not by nifedipine. At peak exercise the number of leads on a 16 point precordial electrocardiogram map that demonstrated greater than or equal to 1 mm ST segment depression was significantly reduced from a mean (SD) of 5.0 (0.4) on placebo to 3.7 (0.6), 2.8 (0.4), and 2.3 (0.7) on nifedipine, atenolol, and the combination respectively. Mean resting left ventricular ejection fraction, assessed by gated radionuclide ventriculography, did not change during any active treatment phase but increased significantly during exercise only on nifedipine and the combination. The nifedipine/atenolol combination was the most effective treatment, and the data suggest that nifedipine may be used to best advantage in combination with a beta blocker. Full text Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (798K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References. These references are in PubMed. This may not be the complete list of references from this article. - Dargie HJ, Lynch PG, Krikler DM, Harris L, Krikler S. Nifedipine and propranolol: a beneficial drug interaction. Am J Med. 1981 Oct;71(4):676–682. [PubMed]
- Tweddel AC, Beattie JM, Murray RG, Hutton I. The combination of nifedipine and propranolol in the management of patients with angina pectoris. Br J Clin Pharmacol. 1981 Aug;12(2):229–233. [PubMed]
- Leon MB, Rosing DR, Bonow RO, Lipson LC, Epstein SE. Clinical efficacy of verapamil alone and combined with propranolol in treating patients with chronic stable angina pectoris. Am J Cardiol. 1981 Jul;48(1):131–139. [PubMed]
- Krikler DM, Harris L, Rowland E. Calcium-channel blockers and beta blockers: advantages and disadvantages of combination therapy in chronic stable angina pectoris. Am Heart J. 1982 Sep;104(3):702–708. [PubMed]
- Packer M, Leon MB, Bonow RO, Kieval J, Rosing DR, Subramanian VB. Hemodynamic and clinical effects of combined verapamil and propranolol therapy in angina pectoris. Am J Cardiol. 1982 Oct;50(4):903–912. [PubMed]
- Henry PD. Comparative pharmacology of calcium antagonists: nifedipine, verapamil and diltiazem. Am J Cardiol. 1980 Dec 1;46(6):1047–1058. [PubMed]
- Fox K, Selwyn A, Shillingford J. Precordial electrocardiographic mapping after exercise in the diagnosis of coronary artery disease. Am J Cardiol. 1979 Mar;43(3):541–546. [PubMed]
- Peto R, Pike MC, Armitage P, Breslow NE, Cox DR, Howard SV, Mantel N, McPherson K, Peto J, Smith PG. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples. Br J Cancer. 1977 Jan;35(1):1–39. [PubMed]
- Kurnik PB, Tiefenbrunn AJ, Ludbrook PA. The dependence of the cardiac effects of nifedipine on the responses of the peripheral vascular system. Circulation. 1984 May;69(5):963–972. [PubMed]
- Robinson BF, Dobbs RJ, Kelsey CR. Effects of nifedipine on resistance vessels, arteries and veins in man. Br J Clin Pharmacol. 1980 Nov;10(5):433–438. [PubMed]
- Emanuelsson H, Holmberg S. Mechanisms of angina relief after nifedipine: a hemodynamic and myocardial metabolic study. Circulation. 1983 Jul;68(1):124–130. [PubMed]
- Anastassiades CJ. Nifedipine and beta-blocker drugs. Br Med J. 1980 Nov 8;281(6250):1251–1252. [PubMed]
- Opie LH, White DA. Adverse interaction between nifedipine and beta-blockade. Br Med J. 1980 Nov 29;281(6253):1462–1462. [PubMed]
- Robson RH, Vishwanath MC. Nifedipine and beta-blockade as a cause of cardiac failure. Br Med J (Clin Res Ed). 1982 Jan 9;284(6309):104. [PubMed]
- Joshi PI, Dalal JJ, Ruttley MS, Sheridan DJ, Henderson AH. Nifedipine and left ventricular function in beta-blocked patients. Br Heart J. 1981 Apr;45(4):457–459. [PubMed]
- Rowland E, Razis P, Sugrue D, Krikler DM. Acute and chronic haemodynamic and electrophysiological effects of nifedipine in patients receiving atenolol. Br Heart J. 1983 Oct;50(4):383–389. [PubMed]
- Johnston DL, Lesoway R, Humen DP, Kostuk WJ. Clinical and hemodynamic evaluation of propranolol in combination with verapamil, nifedipine and diltiazem in exertional angina pectoris: a placebo-controlled, double-blind, randomized, crossover study. Am J Cardiol. 1985 Mar 1;55(6):680–687. [PubMed]
- Kalff V, Kelly MJ, Jennings GL, Lim YL, Anderson ST, Korner PI, Harper RW, Pitt A. The radionuclide assessment of left ventricular function using graded exercise in normal subjects. Aust N Z J Med. 1980 Oct;10(5):533–539. [PubMed]
- Slutsky R, Karliner J, Ricci D, Schuler G, Pfisterer M, Peterson K, Ashburn W. Response of left ventricular volume to exercise in man assessed by radionuclide equilibrium angiography. Circulation. 1979 Sep;60(3):565–571. [PubMed]
- Dehmer GJ, Lewis SE, Hillis LD, Corbett J, Parkey RW, Willerson JT. Exercise-induced alterations in left ventricular volumes and the pressure-volume relationship: a sensitive indicator of left ventricular dysfunction in patients with coronary artery disease. Circulation. 1981 May;63(5):1008–1018. [PubMed]
- Marshall RC, Wisenberg G, Schelbert HR, Henze E. Effect of oral propranolol on rest, exercise and postexercise left ventricular performance in normal subjects and patients with coronary artery disease. Circulation. 1981 Mar;63(3):572–583. [PubMed]
- Port S, Cobb FR, Jones RH. Effects of propranolol on left ventricular function in normal men. Circulation. 1980 Feb;61(2):358–366. [PubMed]
- Johnston DL, Gebhardt VA, Donald A, Kostuk WJ. Comparative effects of propranolol and verapamil alone and in combination on left ventricular function and volumes in patients with chronic exertional angina: a double-blind, placebo-controlled, randomized, crossover study with radionuclide ventriculography. Circulation. 1983 Dec;68(6):1280–1289. [PubMed]
- Dehmer GJ, Falkoff M, Lewis SE, Hillis LD, Parkey RW, Willerson JT. Effect of oral propranolol on rest and exercise left ventricular ejection fraction, volumes, and segmental wall motion in patients with angina pectoris. Assessment with equilibrium gated blood pool imaging. Br Heart J. 1981 Jun;45(6):656–666. [PubMed]
- Lindsay J, Jr, Nolan NG, Goldstein SA, Bacos JM. Effects of beta-adrenergic blocking drugs on sensitivity and specificity of radionuclide ventriculography during exercise in patients with coronary heart disease. Am Heart J. 1983 Aug;106(2):271–278. [PubMed]
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