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A comparison of the acute haemodynamic effects of nisoldipine and nifedipine during treatment with atenolol in patients with coronary artery disease
Author(s) -
DONALDSON KIRSTEEN M.,
DAWKINS KEITH D.,
WALLER DEREK G.
Publication year - 1993
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/j.1365-2125.1993.tb00370.x
Subject(s) - nisoldipine , medicine , nifedipine , atenolol , cardiac index , vascular resistance , blood pressure , cardiology , stroke volume , hemodynamics , heart rate , anesthesia , cardiac output , angina , mean arterial pressure , myocardial infarction , calcium
1 The acute haemodynamic effects of intravenous nisoldipine (1, 2, 4 μg kg −1 ) and nifedipine (2.5, 5, 10 μg kg −1 ) were compared in a randomised, within‐patient crossover study. Fifteen male patients with stable angina pectoris treated with atenolol were studied after undergoing routine cardiac catheterisation. 2 Nisoldipine caused a dose‐related fall in systemic vascular resistance (maximum 22%) associated with an increase in heart rate and cardiac index (18%) and a fall in mean arterial pressure (7%). 3 By contrast, nifedipine was associated with a significant increase in heart rate but systemic vascular resistance, cardiac index and mean arterial pressure remained unaltered. 4 At doses with equivalent effects on heart rate (2 μg kg −1 nisoldipine; 10 μg kg −1 nifedipine) acute dosing with nisoldipine caused a significantly greater fall in systemic vascular resistance and increase in cardiac index, whilst nifedipine caused a greater reduction in stroke volume index and left ventricular stroke work index. 5 The results suggest that, when combined with atenolol, acute dosing with nisoldipine may have a more complementary haemodynamic profile than nifedipine. The implications of this finding for chronic oral dosing in patients with impaired left ventricular function should be evaluated.