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[ Combined therapy with isosorbide dinitrate, propranolol and nifedipine in patients with chronic ischemic heart

G A Glezer, N P Moskalenko, V A Gaponenko

    Kardiologiia
    |January 1, 1992
    PubMed

    Insights

    Combination therapy using propranolol, nifedipine, and isosorbide dinitrate significantly improves anti-anginal, antihypertensive, and antiarrhythmic effects in patients with stable effort angina. This approach enhances physical fitness more than monotherapy.

    Area of Science:

    • Cardiology
    • Pharmacology

    Context:

    • Stable effort angina management requires effective therapeutic strategies.
    • Monotherapy with individual anti-anginal drugs may not be sufficient for all patients.

    Purpose:

    • To evaluate the efficacy of a triple-drug combination therapy (propranolol, nifedipine, isosorbide dinitrate) for stable effort angina.
    • To compare the effects of combination therapy versus monotherapy on anti-anginal, antihypertensive, antiarrhythmic, and physical fitness parameters.

    Summary:

    • Forty-six patients with stable effort angina received combination therapy, demonstrating superior anti-anginal, antihypertensive, and antiarrhythmic effects compared to monotherapy.
    • The combination therapy resulted in moderate reductions in heart rate and peripheral resistance without significant orthostatic disturbances.
    • Exercise testing showed less ST-segment depression, reduced pressor responses, higher heart rate, and increased cardiac index with combination therapy, leading to greater improvements in physical fitness.

    Impact:

    • Combination therapy is indicated for patients with stable effort angina unresponsive to monotherapy.
    • Dual-drug therapy is recommended for patients with concurrent essential hypertension and cardiac arrhythmias.
    • This therapeutic approach offers a more effective management strategy for complex angina cases, improving patient outcomes and physical capacity.

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