A double-blind randomized trial of propranolol and verapamil in the treatment of effort angina.

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Abstract
In 18 patients with stable effort angina, verapamil, 80 mg 4 times daily, was compared with propranolol, 80 mg 4 times daily, in a double-blind, placebo-controlled trial to assess the effects on anginal threshold, exercise capacity and left ventricular function measured by gated equilibrium blood pool scanning. Both propranolol and verapamil improved exercise capacity (placebo 424 .+-. 135 W-min; propranolol 513 .+-. 168 W-min, P < 0.01; verapamil 545 .+-. 215 W-min, P < 0.005) and prolonged the time to 1 mm of ST depression (placebo 4.5 .+-. 1.3 min; propranolol 7.4 .+-. 1.4 min, P < 0.005; verapamil 6.6 .+-. 1.9 min, P < 0.005). At rest, the mean left ventricular ejection fraction did not change significantly during drug therapy (placebo 57 .+-. 13%, propranolol 55 .+-. 12%, verapamil 55 .+-. 13%). While taking placebo, all 18 patients had a decrease in exercise ejection fraction. In contrast, 12 patients taking propranolol and 14 patients taking verapamil had a 5% or greater increase in ejection fraction during exercise. Verapamil is an effective primary therapy and a satisfactory alternative to propranolol in patients with stable effort angina.