Monotherapy of stable angina with nicardipine hydrochloride: Double-blind, placebo-controlled, randomized study

M. Gheorghiade, D. A. Weiner, S. Chakko, J. N. Lessem, M. D. Klein

Research output: Contribution to journalArticle

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Abstract

The effect of nicardipine hydrochloride, a calcium-channel blocking agent, was studied in 46 patients with stable angina in a double-blind, placebo-controlled, randomized, repeated cross-over protocol, using a 30 or 40 mg dose of nicardipine or placebo three times a day. Mean resting heart rate and blood pressure did not change significantly with 30 mg nicardipine; heart rate increased from 81 ± 10 to 88 ± 13 beats min-1, systolic blood pressure decreased from 129 ± 18 to 119 ± 16 mmHg, and diastolic blood pressure from 81 ± 12 to 74 ± 11 mmHg (P < 0.01 for all three variables) with a 40 mg dose. Using a treadmill exercise protocol, mean exercise duration increased from 5.4 ± 1.8 to 6.0 ± 1.8 min (P < 0.01) with 30 mg nicardipine, and from 5.8 ± 1.7 to 6.6 ± 1.9 min (P < 0.01) with 40 mg. Time to onset of angina increased from 4.6 ± 1.9 to 5.2 ± 1.7 min (P < 0.05) with 30 mg and from 5.1 ± 1.8 to 5.7 ± 1.8 min (P = NS) with 40 mg. Mean anginal frequency and sublingual nitroglycerin consumption were low during the cross-over placebo period and did not change significantly during therapy with nicardipine. Non-cardiac side-effects were mild and required the withdrawal of only one patient from the study. However, during nicardipine therapy four patients had unstable angina and two developed a non-Q wave myocardial infarction. Of these patients, five were receiving a β-adrenergic blocker that was discontinued prior to the study. It is concluded that nicardipine had only a mild positive effect on exercise duration. As observed with other dihydropyridines, nicardipine has the potential to precipitate important ischaemic events in patients with stable angina, particularly when started after discontinuing a β-adrenergic blocking agent.

Original languageEnglish
Pages (from-to)695-701
Number of pages7
JournalEuropean Heart Journal
Volume10
Issue number8
StatePublished - Jan 1 1989

Fingerprint

Nicardipine
Stable Angina
Blood pressure
Blood Pressure
Exercise
Placebos
Heart Rate
Therapy
Crossover
Dose
Unstable Angina
Exercise equipment
Myocardial Infarction
Beat
Calcium
Adrenergic Antagonists
Precipitates
Dihydropyridines
Nitroglycerin
Calcium Channels

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Statistics, Probability and Uncertainty
  • Applied Mathematics
  • Physiology (medical)
  • Physiology

Cite this

Gheorghiade, M., Weiner, D. A., Chakko, S., Lessem, J. N., & Klein, M. D. (1989). Monotherapy of stable angina with nicardipine hydrochloride: Double-blind, placebo-controlled, randomized study. European Heart Journal, 10(8), 695-701.

Monotherapy of stable angina with nicardipine hydrochloride : Double-blind, placebo-controlled, randomized study. / Gheorghiade, M.; Weiner, D. A.; Chakko, S.; Lessem, J. N.; Klein, M. D.

In: European Heart Journal, Vol. 10, No. 8, 01.01.1989, p. 695-701.

Research output: Contribution to journalArticle

Gheorghiade, M, Weiner, DA, Chakko, S, Lessem, JN & Klein, MD 1989, 'Monotherapy of stable angina with nicardipine hydrochloride: Double-blind, placebo-controlled, randomized study', European Heart Journal, vol. 10, no. 8, pp. 695-701.
Gheorghiade, M. ; Weiner, D. A. ; Chakko, S. ; Lessem, J. N. ; Klein, M. D. / Monotherapy of stable angina with nicardipine hydrochloride : Double-blind, placebo-controlled, randomized study. In: European Heart Journal. 1989 ; Vol. 10, No. 8. pp. 695-701.
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