Nifedipine gastrointestinal therapeutic system versus atenolol in stable angina pectoris. The Netherlands Working Group on Cardiovascular Research (WCN).

The gastrointestinal therapeutic system formulation of nifedipine enables a once-daily dosing resulting in predictable, relatively constant plasma concentrations. To evaluate the efficacy and safety of this formulation and to compare this with the beta-blocker atenolol, we conducted a double-blind, randomised, multi-centre study in 129 male patients with documented exercise induced angina pectoris. After 4 weeks' treatment, nifedipine (60 mg), improved time to onset of 0.1 mV ST-segment depression from 536 s by 72 +/- 117s, time to onset of pain from 619 s by 56 +/- 120 s, and total exercise time from 685 s by 40 +/- 88 s. Atenolol 100 mg, had a comparable effect, time to onset of 0.1 mV ST-segment depression improved from 496 s by 53 +/- 129 s, time to onset of pain from 572 s by 57 +/- 118 s, and total exercise time from 653 s by 33 +/- 99 s. Between group analysis revealed no statistically significant differences for these exercise parameters. Atenolol, but not nifedipine, significantly reduced heart rate and systolic blood pressure at rest and during exercise (P < 0.001 between groups), indicating different modes of action of the drugs. With regard to safety, both drugs were generally well tolerated. There were significantly (P = 0.01) more vasodilation related side effects with nifedipine. These data demonstrate that gastrointestinal therapeutic system formulation of nifedipine and atenolol as once-daily monotherapy are equally effective and safe, but with different effects on exercise parameters.
AuthorsR J de Vries, A F van den Heuvel, D J Lok, R J Claessens, P J Bernink, W H Pasteuning, J H Kingma, P H Dunselman
JournalInternational journal of cardiology (Int J Cardiol) Vol. 57 Issue 2 Pg. 143-50 (Dec 6 1996) ISSN: 0167-5273 [Print] IRELAND
PMID9013266 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Adrenergic beta-Antagonists
  • Vasodilator Agents
  • Atenolol
  • Nitroglycerin
  • Nifedipine
  • Administration, Oral
  • Adrenergic beta-Antagonists (administration & dosage, therapeutic use)
  • Aged
  • Angina Pectoris (diagnosis, drug therapy, physiopathology)
  • Atenolol (administration & dosage, therapeutic use)
  • Double-Blind Method
  • Drug Administration Schedule
  • Electrocardiography
  • Exercise Test
  • Exercise Tolerance (drug effects)
  • Humans
  • Male
  • Middle Aged
  • Nifedipine (administration & dosage, adverse effects)
  • Nitroglycerin (administration & dosage)
  • Treatment Outcome
  • Vasodilator Agents (administration & dosage, adverse effects)

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