[Does captopril produce an antianginal effect in patients with stable exercise-induced angina pectoris?]

Captopril (C), isosorbide dinitrate (ID), and nifedipine (N) were evaluated for antianginal effects (AAE) in 12 patients with ischemic heart disease. The effects were assessed by treadmill exercise tests performed before and repeatedly 1, 2, 3, and 6 hours after the single dose of a drug or placebo. C, ID, and N were given in doses of 50, 10, and 20 mg, respectively. The drugs were equally effective in lowering systolic blood pressure at rest. Unlike ID and N, C failed to affect the duration of exercise testing until an anginal episode occurred and the magnitude of ST-segment depression at the same exercise intensity. ID and N caused a significant increase in the duration of exercise and a decrease in ST-segment depression during exercise 1-3 h later. An individual analysis has shown that C, ID, and N produced an antianginal effect only in 2, 9, and 10 patients, respectively. Thus, C is unable to show a substantial antianginal effect.