[Nisoldipine in stable angina pectoris. Efficacy and tolerance in comparison with diltiazem]

Following a one-week placebo-controlled washout phase, 24 patients with stable angina pectoris (ST segment depression under ergometric exercise greater than or equal to 0.2 mV) were monitored and randomized to three months treatment with 1 x 10 mg nisoldipine/day or 3 x 60 mg diltiazem/day. Ergometries were performed 2 hours after administration of the first medication, and after 6 weeks and 3 months of treatment. Other parameters were the weekly incidence of angina pectoris attacks, and nitrate consumption, as well as laboratory tests prior to and at the end of treatment. Resting blood pressure and heart rate were only marginally influenced by both medications. The rate-pressure product at maximum ergometric load decreased by about 6% under both nisoldipine and diltiazem. The ST segment depression at maximum work load decreased under nisoldipine by approximately 75% (from 0.27 to 0.07 mV), and under diltiazem by about 55% (from 0.28 to 0.13 mV; p less than or equal to 0.01). In the nisoldipine and diltiazem groups, the number of weekly angina pectoris attacks decreased from an initial 3.4 and 3.3, respectively, to 0.16 and 1.0, respectively, after 6 weeks, and 0.14 and 0.9, respectively, after 3 months' treatment (p less than or equal to 0.01). The weekly consumption of nitrate decreased accordingly. The present data show that, in particular during long-term treatment of angina pectoris, the once-daily dose of 10 mg nisoldipine is superior to diltiazem 3 x 60 mg/day.