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A comparison of diltiazem and atenolol in angina
Insights
Diltiazem and atenolol both effectively reduced angina attacks and nitroglycerin use in coronary heart disease patients. No significant differences were found between the drugs, though diltiazem had fewer side effects.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Coronary heart disease (CHD) is a leading cause of mortality worldwide.
- Effective management of angina symptoms is crucial for improving patient quality of life.
Purpose of the Study:
- To compare the efficacy and safety of diltiazem versus atenolol in patients with coronary heart disease.
- To evaluate the impact of these drugs on anginal attack frequency, nitroglycerin requirements, well-being, and exercise tolerance.
Main Methods:
- A double-blind, randomized trial was conducted with 78 patients diagnosed with coronary heart disease.
- Patients underwent a 2-week control period, followed by 6 weeks of treatment with either diltiazem or atenolol.
- Daily patient records documented anginal attacks, nitroglycerin use, well-being, and exercise tolerance.
Main Results:
- Both diltiazem and atenolol demonstrated highly significant reductions in anginal attack rates and nitroglycerin requirements.
- Significant improvements were observed in patient well-being and exercise tolerance with both treatments.
- No statistically significant differences in efficacy were found between diltiazem and atenolol.
- Diltiazem exhibited a very low incidence of side effects, with no treatment omissions due to adverse events, unlike atenolol where three patients discontinued treatment.
Conclusions:
- Diltiazem and atenolol are both effective in managing symptoms of coronary heart disease.
- Diltiazem presents a favorable side effect profile compared to atenolol in this patient cohort.
- Further research may explore long-term outcomes and comparative effectiveness in diverse patient populations.
Abstract:
Diltiazem was compared to atenolol in a double-blind trial involving 78 patients suffering from coronary heart disease. Following a 2 week control period, patients were randomly allocated to 6 weeks treatment with one or the other drug. The patients themselves made daily records of anginal attacks, trinitrate requirements, well-being and exercise tolerance. With both drugs there were highly significant reductions in the anginal attack rate and trinitrate requirements, and significant improvement on the other measures. However, there were no significant between drug differences. The incidence of side effects with diltiazem was very low and no patient had to omit treatment for this reason, although three patients did so on atenolol.