This study was performed to compare the effects of
nifedipine retard and
angiotensin-converting enzyme (
ACE) inhibitors on the progression of
coronary atherosclerosis by means of quantitative coronary angiogram. Coronary angiogram was performed before the start of the study and during the 3-year treatment period. This study was conducted on the assumption that possible coronary vasodilation, which may be caused by
nifedipine, was excluded by administration of sufficient
isosorbide dinitrate. The changes from the baseline in the minimum lumen diameter of the coronary artery in all measured segments were negligible in the
nifedipine group (+0.02+/-0.27 mm; P=0.543), whereas they were significantly reduced in the
ACE inhibitor group (-0.12+/-0.27 mm; P<0.001), with a significant difference observed between the groups (P=0.002). The number of progressors in the
nifedipine group was significantly lower than that in the
ACE inhibitor group (P=0.019), and there was also a significant difference between the groups in the number of patients in whom > or =1 lesion developed
after treatment (P=0.040). However, the changes of minimum lumen diameter stratified by baseline percent diameter
stenosis demonstrated that progression of
coronary atherosclerosis was suppressed in the
nifedipine group for lesions with a percent diameter
stenosis of < or =40 but was suppressed in both groups for those with a percent diameter
stenosis of > or =41. This study suggests that
nifedipine retard and
ACE inhibitors may be effective in suppression of progression of
coronary atherosclerosis, and that
nifedipine in particular may be effective for mild to moderate
stenosis.