Long‐term double‐blind evaluation of amlodipine and nadolol in patients with stable exertional angina pectoris

The efficacy and tolerability of amlodipine 2.5–10 mg once daily was compared with nadolol 40–160 mg once daily in a long‐term double‐blind parallel‐group study in patients with stable exertional angina pectoris. A total of 80 patients were randomized to receive amlodipine or nadolol for 26 weeks after a 2‐week single‐blind placebo run‐in period. The effects of amlodipine and nadolol on total exercise time were minimal and not significantly different. However, amlodipine produced a slightly but not significantly greater increase in time to onset of angina than nadolol (+21% amlodipine; +8% nadolol). No significant differences were noted between amlodipine and nadolol on ST‐segment depression, angina attack rate, or nitroglycerin consumption. A slightly greater improvement was attained after amlodipine on patient and investigator assessments of treatments. A statistically significant difference (p < 0.0001) was found between treatments on the effects on myocardial oxygen requirements (as assessed by the rate pressure product). Nadolol produced a reduction of 29% compared with a slight reduction of 4% with amlodipine. Fewer side effects were reported with amlodipine (43%) than with nadolol (83%) (p<0.0001), resulting in discontinuation of therapy in three amlodipine and four nadolol patients. Long‐term treatment with amlodipine and nadolol produced comparable effects in patients with angina pectoris, with fewer side effects being reported after treatment with amlodipine.