CALCIUM-ANTAGONISTS DILTIAZEM AND NIFEDIPINE - COMPARATIVE EFFICACY IN SHORT-TERM (SINGLE-DOSE) AND LONG-TERM REGIMENS IN PATIENTS WITH STABLE ANGINA OF EFFORT

Aim. To compare efficacy of diltiazem and nifedipine in single dose an d long-term treatment Materials and methods. A randomised double-blind cross-over study enrolled 17 patients suffering from coronary heart d isease (CHD) with stable angina of effort (SAE). For 1 month, each pat ient 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 pha rmacodynamic test after the initial dose and in the end of each treatm ent course. Results. In 14 eligible patients both drugs reduced the nu mber of SAE attacks and nitroglycerin tablets, diltiazem efficiency be ing somewhat higher. Single doses of diltiazem and nifedipine produced the same action. In long-term treatment nifedipine effect became shor ter, diltiazem effect did not change. Before the morning dose of nifed ipine (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. Conclusion. In long-term treatment of CHD with SAE: diltiasem is more effective and safe than nifedipine.