1 The cardiovascular responses to handgrip exercise have been studied in ten patients with uncomplicated essential hypertension in a randomized crossover study of propranolol and prazosin. 2 Isometric handgrip exercise was performed with a calibrated strain gauge dynamometer at 30% of maximum voluntary contraction for 3 min. 3 Blood pressure and heart rate were measured in the supine position at rest and in the last 10 s of the exercise period. 4 These exercise studies were undertaken at the end of a run-in period and at the end of 1 month's optimal therapy with the two drugs. 5 The active treatment periods were separated by a 2 weeks placebo washout period. 6 Both drugs lowered the supine and standing systolic and diastolic pressures and there was no difference between these drugs in their effect on these variables. 7 Propranolol lowered the resting heart rate and neither drug suppressed the pressor response to isometric exercise. 8 The degree of pressure rise was similar with both drugs but propranolol suppressed isometric exercise-induced tachycardia.
SUMMARYWe have studied the effects of chronic oral verapamil therapy on exercise performance in 26 patients with arteriographically proven coronary disease and positive exercise stress tests. Maximal, multistage treadmill exercise tests were performed before and after 2, 4, and 8 weeks therapy with verapamil 120mg t.i.d. The time to angina and the distance walked increased from 279 to 452sec and from 255 to 443 meters respectively. The frequency of anginal attacks decreased from 24 to 9 per week after 8 week treatment while the nitroglycerin consumption decreased from 20 to 8 tablets per week. Functional aerobic impairment improved from 42.7% to 29.3% whilst there was no change in pressure-rate product, cumulative ST segment depression or EEV1/FVC ratios. Additional Indexing Words: Slow channel calcium blockade Multistage treadmill exercise Functional aerobic impairmentCumulative ST depression Pressure-rate product ERAPAMIL, a papaverine derivative, is a calcium ion antagonist, which selectively blocks the slow channel by inhibiting the slow inward ionic current carried by calcium ions.1),2) It has been used extensively as an antiarrhythmic agent.3)-6) Its use in angina has been controversial.7),8) The conflicting results of these reports could be due to inadequate dosage, too short a trial period and lack of an objective assessment of drug efficacy.In patients with angina, exercise tests are frequently used to evaluate the effect of a therapeutic intervention, both in terms of changes in exercise capacity and the amount of ST segment depression associated with the development of anginal pain, perhaps reflecting the degree of myocardial
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