LONG-TERM MONOTHERAPY OF ANGINA PECTORIS WITH DILTIAZEM

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Abstract
Eighteen patients with exertional angina were treated with diltiazem (360 mg/day). Serial exercise testing was performed and the results were compared to evaluations when patients were receiving placebo at the initiation and termination of the study. Serial exercise tests indicated significant improvement in duration of exercise (+18%, P < 0.001), time to 1 mm ST depression (+32%, P < 0.005) and time to angina (+46%, P < 0.001) when patients were receiving diltiazem. During diltiazem treatment, there was a signficant reduction in myocardial O2 demand as indicated by the change in submaximal pressure rate product. This may contribute to the beneficial effect of diltiazem in patients with exertional angina. The reduction in pressure rate product was due primarily to a change in heart rate. Diltiazem is apparently an effective long-term monotherapy for angina; no evidence of drug tachyphylaxis was apparent after a total of 16 mo. treatment with diltiazem.

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