Verapamil versus placebo in relieving stable angina pectoris

Area of Science:

• Cardiology
• Pharmacology

Background:

• Stable, effort-induced angina remains a significant clinical challenge.
• Current antianginal therapies have limitations in efficacy and side effect profiles.

Purpose of the Study:

• To evaluate the efficacy and safety of verapamil in patients with stable, effort-induced angina.
• To determine the optimal dosage of verapamil for antianginal effects.

Main Methods:

• A double-blind, placebo-controlled crossover study was conducted following single-blind dose titration of verapamil (240, 360, 480 mg/day).
• Patients underwent graded exercise stress tests to assess exercise duration.
• Anginal episodes and nitroglycerin consumption were recorded weekly.

Main Results:

• Verapamil significantly increased exercise duration compared to placebo (p < 0.001).
• Weekly anginal episodes and nitroglycerin use were significantly reduced with verapamil (p < 0.05).
• 16 out of 26 patients improved at 240 or 360 mg/day; 480 mg/day did not offer additional benefit but increased side effects.

Conclusions:

• Verapamil is an effective antianginal agent for stable, effort-induced angina.
• The most efficacious dose appears to be 360 mg/day, balancing efficacy and tolerability.
• Higher doses (480 mg/day) are associated with increased side effects.