Krikler D M
Am J Cardiol. 1987 Jan 30;59(3):95B-100B. doi: 10.1016/0002-9149(87)90088-9.
Stable angina pectoris classically occurs on exertion or in response to other well-defined stress, and can be treated successfully, both in regard to symptoms and ability to undertake more exertion, with available calcium antagonists. Numerous reports suggest that response to calcium antagonists is similar to that with beta-adrenergic blockers, although the latter tend to show somewhat greater efficacy. Advantages in favor of calcium antagonists include the relative freedom from side effects that may occur with beta-adrenergic antagonists; the 2 types of substances can be combined usefully and given to the vast majority of patients requiring medication for angina. Left ventricular failure is a relative contraindication to both calcium antagonists and beta-adrenergic blockers, and thus to the combination. With calcium antagonists, however, the negative inotropic effects are often balanced by the associated peripheral vasodilatation. Where medical management of chronic stable angina is considered, calcium antagonists offer a reasonable alternative to beta blockers, and the use of the combination is highly effective, more so than either substance alone.
稳定型心绞痛通常在运动时或对其他明确的应激源产生反应时发作，就症状和进行更多运动的能力而言，使用现有的钙拮抗剂能够成功治疗。大量报告表明，钙拮抗剂的疗效与β-肾上腺素能阻滞剂相似，尽管后者的疗效往往略高。钙拮抗剂的优势包括相对没有β-肾上腺素能拮抗剂可能出现的副作用；这两种药物可以有效联合使用，用于绝大多数需要药物治疗心绞痛的患者。左心室衰竭是钙拮抗剂和β-肾上腺素能阻滞剂的相对禁忌证，因此也是两者联合使用的相对禁忌证。然而，对于钙拮抗剂来说，负性肌力作用往往会被相关的外周血管扩张所平衡。在考虑慢性稳定型心绞痛的药物治疗时，钙拮抗剂是β受体阻滞剂的合理替代药物，联合使用比单独使用任何一种药物都更有效。
