Beneficial effects of diltiazem and propranolol, alone and in combination, in patients with stable angina pectoris.

J Kenny, P Kiff, J Holmes, D E Jewitt

The antianginal effects of diltiazem 180 mg/day and propranolol 240 mg/day, alone and in combination, were investigated in 15 patients with effort related angina in a double blind placebo controlled crossover trial, with each period of treatment lasting four weeks. Patients performed a symptom limited treadmill exercise test at the end of each period of treatment. Mean (SEM) time to onset of angina was increased from 293(32) s when receiving placebo to 347(38) s when receiving diltiazem alone, to 350(30) s when receiving propranolol alone, and further to 421(34) s when receiving diltiazem and propranolol combined. Similar changes occurred in the duration of exercise testing and time to 1 mm ST segment depression. The sum of ST segment depression at peak exercise was reduced by both diltiazem and propranolol alone compared with placebo, and combination treatment produced a further significant improvement. Rate pressure product was significantly reduced at rest and at peak exercise after propranolol alone and combination treatment. The study clearly showed the superior value of diltiazem and propranolol combined in effort related angina when compared with either drug used alone.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Gibbons, R. J., Chatterjee, K., Daley, J., Douglas, J. S., Fihn, S. D., Gardin, J. M., Grunwald, M. A., Levy, D., Lytle, B. W., O'Rourke, R. A., Schafer, W. P., Williams, S. V., Ritchie, J. L., Gibbons, R. J., Cheitlin, M. D., Eagle, K. A., Gardner, T. J., Garson, A. Jr, Russell, R. O., Ryan, T. J., Smith, S. C. Jr (1999). ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Chronic Stable Angina). J Am Coll Cardiol 33: 2092-2197 [Full Text]  
• Heidenreich, P. A., McDonald, K. M., Hastie, T., Fadel, B., Hagan, V., Lee, B. K., Hlatky, M. A. (1999). Meta-analysis of Trials Comparing {beta}-Blockers, Calcium Antagonists, and Nitrates for Stable Angina. JAMA 281: 1927-1936 [Abstract] [Full Text]  
• Strauss, W. E., Parisi, A. F. (1988). Combined Use of Calcium-Channel and Beta-Adrenergic Blockers for the Treatment of Chronic Stable Angina: Rationale, Efficacy, and Adverse Effects. ANN INTERN MED 109: 570-581 [Abstract]