[Propranolol-nifedipine combination in the treatment of exercise-induced asthma]

The therapeutic effects of the association of propranolol (P) and nifedipine (N) were compared with those of propranolol alone in the treatment of effort angina. Ten patients under 65 years of age with stable effort angina confirmed by stress testing and coronary arteriography were studied. The criterion of selection was inadequate improvement of symptoms with the betablocker alone, prescribed in first intention. The patients were divided into two groups (A and B) at random: --Phase I (2 weeks) : group A : P 80 mg/day + N 30 mg/day, group B : P 80 mg/day + Placebo 3 tablets/day; --Phase II (2 weeks) : group A : P 80 mg/day + Placebo 3 tablets/day, group B : P 80/day. The results of this cross-over trial were assessed blind. The association N + P compared to P alone led to a clinical improvement in 7 out of 10 patients, a clear cut increase in maximal exercise capacity (44%), a reduction in ST depression of 0.8 mm and to the disappearance of effort angina in half the patients. The haemodynamic tolerance of this drug association was good. These statistically significant differences between the P + N and P + placebo treatment periods demonstrate that this drug association is beneficial in patients with effort angina who are inadequately relieved by betablocker therapy alone.