Short-term effect of nifedipine on effort tolerance in patients with angina pectoris

The short-term effect of oral nifedipine on effort tolerance was tested in 10 patients with effort angina pectoris and a positive effort test (GXT). The patients had four symptom-limited GXTs, using the Bruce protocol, on each day of the study at 0800, 1000, 1400, and 1800 hours. They received four doses of 10 mg oral nifedipine on one day and four doses of placebo on the other, each dose given half an hour prior to each GXT. Values with nifedipine were compared to values with placebo at the same time during each day. Nifedipine improved effort tolerance by 0.5 +/- 0.6 min (p = NS) on the first GXT (mean +/- SEM), by 1.2 +/- 0.6 min (p = NS) on the second GXT, by 1.0 +/- 0.3 min (p less than 0.01) on third GXT, and by 1.3 +/- 0.3 min (p less than 0.01) on the fourth GXT. Improvement of effort tolerance was associated with a fall in resting blood pressure and less ST depression; these changes were statistically significant only on the fourth GXT, which may indicate a cumulative effect of subsequent doses of nifedipine.