The effect of verapamil in patients with asymptomatic stress-induced ischemia

In 25 patients with asymptomatic exercise-induced positive stress tests heart rate, blood pressure, double product, exercise duration, and ST-segment changes were studied prior to and 4 weeks after administration of 120 mg of verapamil therapy three times a day. Significant improvement was observed at rest and at peak exercise in heart rate, pressure values, double product, and maximal ST depression with a prolongation of exercise duration. Measurements at the same work load in the post-verapamil test as at the pretreatment peak exercise showed a slower heart rate, lower blood pressure, less double product, and less ST depression as a more pronounced expression of drug efficacy. There was no deterioration in any parameter. In conclusion, improved myocardial performance can be demonstrated in asymptomatic ischemic patients when treated with verapamil, and this effect is particularly evident when data are compared with equal exercise duration in the posttreatment test as with peak exercise prior to therapy.