[Captopril in the therapy of stable angina pectoris]

In 28 patients with chronic angina pectoris grade II-III (NYHA) the authors investigated the antianginous effect of captopril. All patients had a normal blood pressure and the diagnosis was confirmed by coronary angiography. The investigation was made in three sub-groups as a simple crossover experiment with a randomized onset. In 10 patients without dysfunction (group A) and eight with severe left ventricular dysfunction (group C) a short-term comparative study of captopril and placebo was made; 10 patients of group B took first for 7 days diltiazem, 3 X 60 mg, and then during subsequent weeks the action of diltiazem with placebo was compared and the action of diltiazem combined with captopril 3 X 25 mg per day. Captopril significantly reduced the blood pressure and Robinson's index at rest and during activity. It protracted significantly the time before the development of stenocardia in patients with left ventricular dysfunction and in the group treated with diltiazem where it reduced even further the incidence of stenocardias. ACE inhibitors may apparently enhance the effectiveness of diltiazem in normotensive patients with angina pectoris and it may be assumed that it will have an even more potent effect in concurrent hypertension or left ventricular dysfunction.