Evaluation of Antianginal Effects of Nisoldipine (BAY k 5552) by Serial Multistage Treadmill Exercise Testing

To investigate the antianginal effects of nisoldipine, a placebo-controlled study was performed using 10 patients with stable angina pectoris on effort. Anginal symptom-limited treadmill exercise tests were performed before and 2, 4, 7, and 24 hours after a single oral dose of placebo at 10: 00 am. A few days later, the exercise test was again performed before and after the administration of 10 mg of nisoldipine according to the same schedule followed in the placebo trial.Between tests before placebo and nisoldipine administration, there were no significant differences in exercise time, pressure- rate product (PRP), or ST deviation at peak exercise.Compared with the placebo trials, the exercise time was significantly prolonged after nisoldipine administration and its increments were 100.1, 74.5, 85.0, and 43.6 sec at 2, 4, 7, and 24 hours after administration, respectively. The plasma concentration of nisoldipine and the increment of exercise time reached maxima at 2 hours after nisoldipine administration. Two hours after administration, the peak PRP was significantly greater after nisoldipine administration than after placebo and before nisoldipine administration. The ST deviation at peak exercise was not significanty different between the placebo and nisoldipine trials.This indicates that nisoldipine exerts an antianginal effect for more than 24 hours. It is considered to be a clinicaly useful agent in the management of angina pectoris on effort.