Amlodipine versus slow release Metoprolol in the treatment of Stable exertional Angina pectoris (AMSA)

Objectives-To compare the effects of amlodipine and slow release metoprolol on subjective symptoms and signs of ischaemia during bicycle ergometric ex ercise tests in patients with stable angina pectoris, Design-A randomized double-blind comparison of the two drugs in patients wi th documented coronary disease required to have at least three attacks of a ngina per week and to perform a symptom-limited exercise test with signific ant signs of ischaemia in the EGG. Results-Out of 127 patients, 117 completed the study, Both amlodipine and m etoprolol significantly increased total exercise time, total workload, time to onset of angina and time to 1 mm ST-depression with no significant diff erences between the drugs. Amlodipine was significantly more efficient than metoprolol in reducing ST-depression at maximum workload. Diary data revea led no differences in patients' self-rating of drug effects. Conclusions-Judged by suppression of subjective symptoms and performance on exercise tolerance tests amlodipine represents a useful alternative to met oprolol as monotherapy in stable angina pectoris.