An 8-Week Double-Blind Study of Amlodipine and Diltiazem in Patients with Stable Exertional Angina Pectoris

Bernink, P. J. L. M.; Weerd, Peter De; Cate, Folkert J. Ten; Remme, Willem J.; Barth, Jonathan; Enthoven, Robert; Haagen, F. D. M.; Holwerda, Nicolaas J.; Klomps, H.

doi:10.1097/00005344-199117001-00017

Cited by 20 publications

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“…The present study found that a higher dose of amlodipine (10 mg) achieved additional statistically significant reductions in clinic and home BP compared with the lower dose (5 mg). Amlodipine is known to have vasodilation-induced side effects, including tachycardia (27), flushing (27)(28)(29)(30), and dizziness (28,31), as are other CCBs. Headache (27)(28)(29)(30)(31)(32)(33) and peripheral edema (30,31,34,35) have been reported as particularly prevalent dose-dependent adverse effects.…”

Section: Discussionmentioning

confidence: 99%

“…As shown in Table 1, there were no significant differences in the baseline characteristics between the treatment groups. There were no remarkable adverse events in either group, including tachycardia (27), flushing (27)(28)(29)(30), dizziness (28,31), headache (27)(28)(29)(30)(31)(32)(33), and peripheral edema (30,31,34,35) throughout the study period.…”

Section: Patientsmentioning

confidence: 99%

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Effects of Strict Blood Pressure Control by a Long-Acting Calcium Channel Blocker on Brain Natriuretic Peptide and Urinary Albumin Excretion Rate in Japanese Hypertensive Patients

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

Effects of Strict Blood Pressure Control by a Long-Acting Calcium Channel Blocker on Brain Natriuretic Peptide and Urinary Albumin Excretion Rate in Japanese Hypertensive Patients

et al. 2008

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Amlodipine once a day in stable angina: Double‐blind crossover comparison with placebo

Deedwania

Cheitlin

Das

et al. 1993

Clinical Cardiology

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Summary: Although calcium antagonists form a mainstay of therapy in patients with angina pectoris, the currently available agents have significant limitations. Nifedipine, diltiazem, and verapamil are all high-clearance agents with significant hepatic extraction and rapid clearance, leading to limited and shortlived bioavailability necessitating frequent daily administration. In contrast, amlodipine, a dihydropyridine calcium antagonist, has a long half-life of 35-50 h (compared with 3 to 4 h elimination half-life of diltiazem, verapamil, and nifedipine).' After oral doses, the relative bioavailability of amlodipine is high (64%) and absorption is smooth, with peak plasma levels being achieved 6-12 h postdose.' Bioavailability is not affected by the consumption of food.2 In common with other dihydropyridine calcium antagonists, amlodipine is eliminated mainly by metabolism.3 None of the metabolites of amlodipine has significant calcium antagonist effects in humans? In contrast to verapamil or diltiazem, amlodipine has no effect on sinus or atrioventricular node4 and little or no effect on the resting heart rate: Amlodipine does not have any appreciable negative inotropic effect with the relevant clinical dose? Other clinical studies have shown amlodipine to be effective when used once-daily in chronic stable angina and vasospastic angina? Comparative studies indicate that the antianginal efficacy of amlodipine is comparable to the beta blocker nadolo18 and the benzothiazepine calcium antagonist diltia~ern.~ Amlo- dipine has also been found to provide improved antianginal effects when combined to treatment with beta blockers and/or long-acting nitrates.1o. Treatment with amlodipine either as monotherapy or combined with other antianginal therapy for up to 26 weeks shows that efficacy is maintained, with no evidence of tolerance."We evaluated the antianginal efficacy and safety of amlodipine in a placebocontrolled multicenter randomized crossover study in patients with chronic stable angina. Key words angina pectoris, exercise tolerance, amlodiphe MethodsIn this short-term randomized double-blind crossover study (Fig. l), the effects of amlodipine (2.55, and 10 mg) oncedaily were compared with placebo in patients with chronic stable angina. After giving signed, informed consent, patients had all antianginal medications except sublingual nitroglycerin (NTG) withdrawn and entered an initial single-blind placebo period lasting up to 1 week. Patients were then randomized to 1-week double-blind therapy (amlodipine 2.5,5, or 10 mg or placebo) once daily, followed by 1-week therapy with the alternative regimen (amlodipine if placebo was given in the first double-blind period and vice versa). Patients were examined and evaluated on at least one occasion during the initial placebo period, at the end of each double-blind period, and 1 week after completion of the second double-blind period.At each visit, patients attended the clinic 1 h after a light carbohydrate breakfast taken 4 h after the dose. No tobacco or tea, coffee...

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Efficacy and Safety of Calcium Antagonists as Antianginal Agents

Opie¹

1994

Developments in Cardiovascular Medicine

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An 8-Week Double-Blind Study of Amlodipine and Diltiazem in Patients with Stable Exertional Angina Pectoris

Cited by 20 publications

References 0 publications

Effects of Strict Blood Pressure Control by a Long-Acting Calcium Channel Blocker on Brain Natriuretic Peptide and Urinary Albumin Excretion Rate in Japanese Hypertensive Patients

Effects of Strict Blood Pressure Control by a Long-Acting Calcium Channel Blocker on Brain Natriuretic Peptide and Urinary Albumin Excretion Rate in Japanese Hypertensive Patients

Amlodipine once a day in stable angina: Double‐blind crossover comparison with placebo

Efficacy and Safety of Calcium Antagonists as Antianginal Agents

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