Di Pasquale G, Lusa A M, Manini G L, Dominici P, Pinelli G
G Ital Cardiol. 1983 Jul;13(7):32-9.
The comparative efficacy of diltiazem, a new calcium-antagonist drug, and nifedipine were evaluated with computerized treadmill exercise test in 12 patients with stable effort angina. The drugs were administered in a random single-blind fashion in divided doses (diltiazem 60 mg three times daily and nifedipine 10 mg four times daily) over 3 weeks. Maximal exercise tests were performed before and at the end of each 3-week treatment period. Both diltiazem and nifedipine increased the total duration of exercise (p less than 0.001) and the time to appearance of 1.5 mm of ST depression (p less than 0.001). Both drugs reduced resting systolic and diastolic blood pressure; however the effect was greater with nifedipine. Nifedipine, but not diltiazem, caused a significant increase of resting heart rate (p less than 0.05). Both drugs blunted the blood pressure and heart rate response to exercise: nifedipine had a greater effect on the former (p less than 0.001), diltiazem on the latter (p less than 0.05). The rate-pressure product was significantly reduced at rest (p less than 0.01) and submaximal (p less than 0.001), but not maximal exercise with both drugs. The reduction of rate-pressure product is possible as the mechanism by which calcium-antagonist drugs enhance the duration of exercise in the coronary patients. Our results documented a comparable therapeutic efficacy of the two drugs, but side effects were more common with nifedipine.
采用计算机化平板运动试验，对12例稳定型劳力性心绞痛患者评估了新型钙拮抗剂地尔硫䓬和硝苯地平的比较疗效。药物以随机单盲方式分剂量给药（地尔硫䓬每日3次，每次60mg；硝苯地平每日4次，每次10mg），持续3周。在每3周治疗期开始前和结束时进行最大运动试验。地尔硫䓬和硝苯地平均增加了运动总时长（p<0.001）以及出现ST段压低1.5mm的时间（p<0.001）。两种药物均降低了静息收缩压和舒张压；然而硝苯地平的效果更显著。硝苯地平使静息心率显著增加（p<0.05），而地尔硫䓬无此作用。两种药物均减弱了运动时的血压和心率反应：硝苯地平对前者作用更强（p<0.001），地尔硫䓬对后者作用更强（p<0.05）。静息时（p<0.01）和次极量运动时（p<0.001），两种药物的速率-压力乘积均显著降低，但在极量运动时未降低。速率-压力乘积降低可能是钙拮抗剂药物延长冠心病患者运动时长的机制。我们的结果证明两种药物具有相当的治疗效果，但硝苯地平的副作用更常见。
