Nisoldipine is effective and safe in patients with chronic stable anginal syndrome: An exercise test study

The efficacy of nisoldipine 10 mg/daily was evaluated and compared with that of nifedipine 30 mg/daily in a double-blind group comparison study of two similar groups of 15 patients each, all having proven coronary artery disease and chronic stable angina. Each subject underwent clinical evaluation and a submaximal exercise test before, and at 4 and 8 weeks, of continuing therapy. The frequency of anginal pain decreased from (mean±SE) 6.7±6.5 to 1.1±0.5 per week on nisoldipine and from 5.7±3.3 to 1.8±0.5 per week on nifedipine. Exercise tolerance improved significantly for both groups; maximal workload increased from 67.9±3.9 to 73.2±4.1 W (nisoldipine) and from 58.3±6.8 to 65.0±7.2 W (nifedipine), p<0.05 for both. Exercise-induced chest pain was present at baseline in all patients in both groups. On the final exercise test, only 4 patients on nisoldipine and 6 on nifedipine had chest pain on exercise. Time to occurrence of chest pain improved significantly for both groups from 9.0±1.1 to 9.8±1.2 min (nisoldipine) and from 5.5±0.5 to 7.5±0.9 min (nifedipine), p<0.01 for both. Mean ST-segment depression decreased to 43.1±9.7% of baseline (nisoldipine) and to 62.0±15.2% (nifedipine), corresponding to a significant increase in time-to- occurrence of ischemic ST depression from 7.7±0.8 to 8.6±0.9 min (nisoldipine) and from 5.2±0.7 to 6.4±0.8 min (nifedipine) p<0.05 for both. Four patients developed side effects, two from each group. In one patient on nisoldipine, side effects were severe and study medication was discontinued. Thus nisoldipine 10 mg daily is an effective drug in patients with chronic stable anginal syndrome.