Improved efficacy and safety of controlled-release diltiazem compared to nifedipine may be related to its negative chronotropic effect

American Journal of Therapeutics
S K BasuA Lahiri

Abstract

The objective of this study was to assess the safety and efficacy of long-acting preparations of two commonly used calcium antagonists with particular reference to their effects on heart rate. Twenty patients with chronic stable angina were recruited to a double-blind, double-dummy crossover study of controlled-release diltiazem (diltiazem CR) versus sustained-release nifedipine (nifedipine SR) and underwent clinical assessment, symptom and adverse event reporting, and repeated treadmill exercise tests over a 10- to 11-week period. The main outcome measures were heart rate at rest and exercise, incidence of angina and nitroglycerin use, treadmill exercise performance (duration, time to angina, time to 1-mm ST-segment depression, heart rate at equivalent maximal exercise, and maximal ST-segment depression), and adverse events. Diltiazem CR significantly reduced heart rate at rest and equivalent exercise and incidence of angina and nitroglycerin use compared with nifedipine SR. Exercise duration time to angina and time to 1-mm ST-segment depression (but not maximal ST-segment depression) were all significantly improved by diltiazem CR. Diltiazem CR also caused significantly fewer adverse events than nifedipine SR. Calcium antagon...Continue Reading

Citations

Apr 14, 2010·Expert Opinion on Emerging Drugs·Stanley F FernandezWilliam E Boden
Jan 25, 2005·Vascular Pharmacology·Hossein MirkhaniIris Youssef-Zayeh
Mar 19, 2019·The Cochrane Database of Systematic Reviews·Meghan A BohrenÖzge Tunçalp
Aug 11, 2020·International Journal of Hypertension·Gilberto Arias-HernándezMaría Esther Ocharan-Hernández

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antianginal Drugs: Mechanisms of Action

Antianginal drugs, including nitrates, beta-blockers, and calcium channel blockers, are used in the treatment of angina pectoris. Here is the latest research on their use and their mechanism of action.