Comparison of metoprolol and verapamil in the treatment of angina pectoris. 1982

K Arnman, and L Rydén

The cardioselective beta adrenoceptor blocking agent metoprolol was compared with the calcium antagonist verapamil in relation to effects on angina pectoris. Twenty patients with stable, exercise-induced angina pectoris took part in a 14 week study that began with a 4 week single blind placebo period. In the succeeding 4 weeks, verapamil in a daily dose of 360 mg or metoprolol, 200 mg twice daily, was administered in double-blind fashion. After 2 weeks the patients were transferred to a second 4 week period of treatment with the other drug. The number of anginal attacks and the consumption of nitroglycerin tablets were reported. At the end of each treatment period a symptom-limited maximal exercise test was performed. The mean daily rate of anginal attacks and nitroglycerin consumption decreased significantly (p less than 0.01) and to a similar extent with both drugs. Exercise capacity increased from 103 +/- 7 to 113 +/- 7 watts (p less than 0.01) with metoprolol and to 119 +/- 6 watts (p less than 0.01) with verapamil. The increase with verapamil was significantly higher (p less than 0.05) than with metoprolol. Metoprolol caused a substantial reduction in the rate-pressure product both at rest and during exercise (p less than 0.001); this variable was not influenced by verapamil. Adverse effects were only mild to moderate and did not cause the cessation of treatment in any case. In conclusion, metoprolol and verapamil are two effective drugs for treatment of stable exercise-induced angina pectoris. Which drug is preferable as a first choice may depend on possible contraindications to one of these agents rather than on the belief that one is much more effective than the other.

UI MeSH Term Description Entries
D008297 Male Males
D008790 Metoprolol A selective adrenergic beta-1 blocking agent that is commonly used to treat ANGINA PECTORIS; HYPERTENSION; and CARDIAC ARRHYTHMIAS. Beloc-Duriles,Betaloc,Betaloc-Astra,Betalok,CGP-2175,H 93-26,Lopressor,Metoprolol CR-XL,Metoprolol Succinate,Metoprolol Tartrate,Seloken,Spesicor,Spesikor,Toprol,Toprol-XL,Beloc Duriles,Betaloc Astra,CGP 2175,CGP2175,H 93 26,H 9326,Metoprolol CR XL,Toprol XL
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011412 Propanolamines AMINO ALCOHOLS containing the propanolamine (NH2CH2CHOHCH2) group and its derivatives. Aminopropanols
D004311 Double-Blind Method A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment. Double-Masked Study,Double-Blind Study,Double-Masked Method,Double Blind Method,Double Blind Study,Double Masked Method,Double Masked Study,Double-Blind Methods,Double-Blind Studies,Double-Masked Methods,Double-Masked Studies,Method, Double-Blind,Method, Double-Masked,Methods, Double-Blind,Methods, Double-Masked,Studies, Double-Blind,Studies, Double-Masked,Study, Double-Blind,Study, Double-Masked
D005082 Physical Exertion Expenditure of energy during PHYSICAL ACTIVITY. Intensity of exertion may be measured by rate of OXYGEN CONSUMPTION; HEAT produced, or HEART RATE. Perceived exertion, a psychological measure of exertion, is included. Physical Effort,Effort, Physical,Efforts, Physical,Exertion, Physical,Exertions, Physical,Physical Efforts,Physical Exertions
D005260 Female Females
D005996 Nitroglycerin A volatile vasodilator which relieves ANGINA PECTORIS by stimulating GUANYLATE CYCLASE and lowering cytosolic calcium. It is also sometimes used for TOCOLYSIS and explosives. Glyceryl Trinitrate,Anginine,Dynamite,Gilustenon,Nitrangin,Nitro-Bid,Nitro-Dur,Nitrocard,Nitroderm,Nitroderm TTS,Nitroglyn,Nitrol,Nitrolan,Nitrong,Nitrospan,Nitrostat,Perlinganit,Susadrin,Sustac,Sustak,Sustonit,Transderm Nitro,Tridil,Trinitrin,Trinitrolong,Nitro Bid,Nitro Dur,NitroBid,NitroDur,Trinitrate, Glyceryl
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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