Subramanian V B, Bowles M J, Khurmi N S, Davies A B, Raftery E B
Acta Med Scand Suppl. 1984;681:61-73. doi: 10.1111/j.0954-6820.1984.tb08679.x.
The efficacy and safety of verapamil and nifedipine were objectively assessed in patients with chronic stable angina. Twenty four patients entered a double blind randomized cross over trial of nifedipine (10 mg thrice daily) and placebo. In this dosage nifedipine did not show any significant change in exercise duration and the variables obtained using computer assisted exercise testing when compared to placebo. The next stage consisted of another double blind randomized cross over trial comparing the effects of verapamil (120 mg thrice daily) and nifedipine (20 mg thrice daily) with an initial placebo run-in period in 32 patients. At this dose level nifedipine showed a definite and significant improvement in all the objective variables; however an increase in side effects was observed resulting in withdrawal of the drug in seven patients. A common problem was tachycardia precipitating angina after nifedipine ingestion. On the other hand verapamil produced a marked improvement in exercise tolerance and other variables as compared to placebo and nifedipine, was well tolerated and produced a mild bradycardia. This study clearly indicates that verapamil is distinctly superior to nifedipine in efficacy side effects and safety in patients with chronic stable angina. This may be attributable to the differential effect on heart rates induced by these drugs.
在慢性稳定型心绞痛患者中对维拉帕米和硝苯地平的疗效及安全性进行了客观评估。24名患者进入了硝苯地平（每日三次，每次10毫克）与安慰剂的双盲随机交叉试验。在此剂量下，与安慰剂相比，硝苯地平在运动持续时间以及使用计算机辅助运动测试获得的各项指标上均未显示出任何显著变化。下一阶段是另一项双盲随机交叉试验，在32名患者中，先有一个初始安慰剂导入期，然后比较维拉帕米（每日三次，每次120毫克）和硝苯地平（每日三次，每次20毫克）的效果。在此剂量水平下，硝苯地平在所有客观指标上均显示出明确且显著的改善；然而，观察到副作用有所增加，导致7名患者停药。一个常见问题是服用硝苯地平后心动过速引发心绞痛。另一方面，与安慰剂和硝苯地平相比，维拉帕米在运动耐量和其他指标上有显著改善，耐受性良好，且会引起轻度心动过缓。这项研究清楚地表明，在慢性稳定型心绞痛患者中，维拉帕米在疗效、副作用和安全性方面明显优于硝苯地平。这可能归因于这些药物对心率的不同作用。
