Calcium channel blocking drugs for chronic, stable angina

The slow channel calcium blocking drugs have been shown to be efficacious in patients with chronic stable angina. They provide effective first alternative therapy to beta-blockers in preventing recurrent episodes of myocardial ischemia in patients who do not tolerate treatment with beta-blocking drugs because of, for example, pulmonary bronchospasm or hypoglycemia. The calcium blocking drugs often provide an additive effect in reducing anginal episodes when combined with beta-blocking agents and sometimes provide effective relief of chronic stable angina when beta-blocking drugs are unsuccessful. Diltiazem, nifedipine and verapamil are important additions to our therapeutic armentarium for the treatment of exercise-induced angina pectoris.