The effect of the calcium-entry blocker nifedipine on cold-induced digital vasospasm. A double-blind crossover study...

The effects of the calcium-entry blocker nifedipine 20 mg, two 10 mg capsules, t.i.d. in patients with cold-induced digital vasospastic disease of idiopathic or traumatic origin was tested in 28 patients, using double-blind crossover technique on both symptoms and test results. The effect of treatment on digital blood pressure during local cooling was assessed using the Nielsen-Lassen method. Symptomatic improvement was reported by 5 patients during placebo treatment and 17 during nifedipine treatment (p less than 0.01). The symptomatic improvement was significant in the total group of patients and in the group of patients with idiopathic vasospastic disease. The digital blood pressure during local cooling improved significantly with nifedipine at 5, 10, 15 (p less than 0.001) and 20 degrees C (p less than 0.05) for the total study population and for the two subgroups except for the change at 20 degrees C in the IDIOP group. At a digital temperature of 10 degrees C, 2 patients reached normal digital blood pressure during placebo treatment compared to 16 during nifedipine treatment (p less than 0.001). The number of side-effects increased significantly (p less than 0.05) during nifedipine treatment. We consider the use of nifedipine in patients with cold-induced digital vasospastic disease to be of great value, especially in patients with digital vasospastic disease of idiopathic origin.