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Circulation, Vol 66, 710-716, Copyright © 1982 by American Heart Association

ARTICLES

The additive antianginal action of oral nifedipine in patients receiving propranolol: magnitude and duration of effect

M Bassan, D Weiler-Ravell and O Shalev

Ten men with stable angina not completely relieved by full doses of propranolol (mean 218 mg/day) were administered an oral dose of 10 mg of nifedipine or placebo on alternate mornings in a double-blind fashion. Patients had been trained in a protocol that precipitated angina after 3-6 minutes of bicycle exercise. On test days, with propranolol continued, bicycle exercise to angina or fatigue was performed before nifedipine or placebo administration, and hourly thereafter for 8 hours. Mean exercise duration was greater 1 hour after nifedipine than after placebo by 123 seconds (372 +/- 21 vs 249 +/- 16 seconds, p less than 0.001). By the fifth hour, the increase in exercise time was reduced to 93 seconds (p less than 0.001), and a significant, though further diminished, difference of 57 seconds was still present at 8 hours (p less than 0.01). Nifedipine lowered resting systolic blood pressure by 20 mm Hg (p less than 0.001) without appreciably changing heart rate. We conclude that nifedipine is a very effective and reasonably long-acting antianginal supplement to propranolol.