Improvement in exercise performance with nisoldipine, a new second-generation calcium blocker, in stable angina patients

Safety and efficacy of a new dihydropyridine calcium antagonist, nisoldipine, were studied in 15 patients with proved coronary artery disease and positive exercise treadmill tests. After withdrawal of current therapy and a 2-week placebo phase, patients were given nisoldipine 10, 20, and 40 mg daily (divided into two daily doses), each dose for a 2-week period. Exercise treadmill testing was performed twice during the placebo and once at the end of each nisoldipine phase. Maximal duration of exercise increased with all doses of nisoldipine. Time to 1 mm ST segment depression also increased with all doses of nisoldipine. Peak time to angina was similarly prolonged. Peak exercise double product (heart rate X systolic blood pressure) was unaffected by all doses of nisoldipine. Angina frequency and nitroglycerin consumption decreased during nisoldipine therapy in all patients. Side effects from therapy were only minor. Twice daily therapy compared to three to four times daily therapy with other calcium blockers is an advantage of nisoldipine.