Comparison of the antianginal effectiveness of nifedipine, verapamil, and isosorbide dinitrate in patients receiving propranolol: a double-blind study.

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Abstract
Men (10) with stable angina not fully relieved by optimal doses of propranolol were given on each of 4 mornings a single dose of 10 mg nifedipine, 120 mg verapamil, isosorbide dinitrate (5-30 mg, previously titrated to lower systolic blood pressure by 15-20 mm Hg), or placebo, in double-blind fashion. Bicycle exercise to angina was performed hourly for 8 h thereafter. All 3 vasodilators increased exercise time by at least 50% by the 1st h (P < 0.001), with a gradually diminishing effect persisting for 6-8 h (P < 0.01). Although for the group there were no differences in magnitude and duration of effect among the 3 drugs, in 5 of the individual patients there were important differences in response favoring one or another vasodilator. Apparently, nifedipine, verapamil and isosorbide dinitrate are equally effective and reasonably long-acting antianginal supplements to propranolol, although some patients may benefit more from one than another of the 3.