Verapamil and beta-adrenoceptor blockade in the treatment of stable angina pectoris.

1. In a double blind cross-over study the effect of verapamil (Isoptin) 360 mg/d and propranolol 180 mg/d was evaluated in patients with stable angina pectoris. The results of verapamil and propranolol treatment are compared to a single blind placebo period of 2 weeks. 2. Both verapamil and propranolol caused a significant reduction in glyceryl trinitrate tablet consumption, days with angina pectoris and in severe angina attacks compared to placebo. A 50% reduction in angina pectoris attacks and/or glyceryl trinitrate consumption compared to placebo was demonstrated in thirteen of eighteen patients during verapamil treatment (P less than 0.01) and in seven of seventeen patients during propranolol treatment (P greater than 0.05). Of sixteen patients accomplishing both treatment periods, ten improved both on verapamil and propranolol, three on verapamil only, one on propranolol only, one was unchanged and one deteriorated on verapamil and propranolol. During exercise, maximum exercise capacity was increased during verapamil compared to placebo (P less than 0.01) and propranolol (P less than 0.02). Maximum exercise capacity was not increased after propranolol compared to placebo. 3. These findings are in accordance with other reported series, and verapamil is at least as effective as propranolol in the treatment of angina pectoris.