Beneficial effect of adding nifedipine to beta-adrenergic blocking therapy in angina pectoris

To evaluate the effects of adding nifedipine, a calcium antagonist,to chronic beta-blocking therapy, 10 patients with angiographicallyproven coronary artery disease underwent atrial pacing beforeand after sublingual administration of 20 mg nifedipine. Symptomatic,metabolic and haemodynamic responses were monitored at restand during each pacing period. Nifedipine prolonged pacing timeto angina (285 to 421 s. P <0.01), increased lactate extractionratio (5.4 to 26.7%, P <0.05) and produced coronary and peripheralvasodilation. The results demonstrate that nifedipine has abeneficial additive effect, and should play an important rolein the treatment of angina pectoris in patients already on beta-blockingtherapy.