8

Thercapy

Atenolol is favoured over nifedipine in stable angina

A crossover study comparing atenolol and nifedipine in 16 men with stable angina, exercise­induced ischaemia and transient myocardial ischaemia, showed that atenolol produced a significantly greater decrease in the number and duration of silent ischaemic episodes than nifedipine. Both agents produced a significant reduction compared with placebo.

The incidence of adverse effects was lower with atenolol than with nifedipine. Atenolol was associated with a significant reduction in HR while nifedipine had no effect on HR. Diastolic and systolic BP were significantly reduced by both agents.

'Treatment with atenolol may reduce the risk of acute myocardial infarction and sudden cardiac death by suppressing silent ischemic events, particularly during the morning hours when the risk of these events is significantly increased.'

Following a I-week placebo phase, patients randomly received atenolol 50 mg/day and nifedipine 20mg tid for 3 weeks each with a I-week placebo wash-out period between treatments. Atenolol was increased to 100 mg/day and nifedipine to 30mg tid if required. Deedwania Pc. Carbajal EV, Nelson JR, Hait H. Anti·ischemic effects of atenolol versus nifedipine in patients with coronary artery disease and ambulatory silent ischemia. Journal of the American College of Cardiology 17: 963-969, Mar 1991 6712

_ 81utl 1991 INPHARMA® ISSN 0156-1703/91/0608-0008/0$01.00/0 e Adis Itlterfllltiotlal Ltd