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Comparative hemodynamic dose‐response effects of five slow calcium channel—blocking agents in coronary artery disease
Author(s) -
Silke B,
Frais M A,
Midtbo K A,
Verma S P,
Sharma S,
Reynolds G,
Jackson N,
Taylor S H
Publication year - 1987
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1987.167
Subject(s) - nisoldipine , diltiazem , nicardipine , verapamil , amlodipine , medicine , hemodynamics , blood pressure , coronary artery disease , cardiology , heart rate , vascular resistance , anesthesia , pharmacology , nifedipine , calcium
A prospective, randomized study compared the hemodynamic effects of equivalent doses of five slow calcium channel blockers (verapamil, diltiazem, nicardipine, nisoldipine, and amlodipine) in 50 patients with ischemia. After a stable control period, dose‐response curves were constructed for each drug with hemodynamics measured 10 minutes after intravenous boluses. Each drug reduced mean systemic arterial pressure (P < 0.01) and systemic vascular resistance index (P < 0.01). The heart rate increased after nicardipine, nisoldipine, and amlodipine (P < 0.01) but was unchanged after verapamil and reduced after diltiazem (P < 0.01). The left ventricular filling pressure increased after amlodipine (P < 0.05) and verapamil (P < 0.01) but was unchanged with the other compounds. Cardiac index increased substantially after the dihydropyridines (P < 0.01), with little change after verapamil or diltiazem. Cardiac double product fell only after verapamil and diltiazem. These studies provide quantitation of the comparative actions of acute intravenous calcium channel blockade in coronary disease. Clinical Pharmacology and Therapeutics (1987) 42, 381–387; doi: 10.1038/clpt.1987.167