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Both metoprolol and diltiazem caused a significant increase in time to ischemic threshold during exercise and a significant decrease of maximum ST\u2010segment depression (during exercise and ambulatory ECG monitoring) and in the average number of daily ischemic episodes. Only metoprolol significantly reduced heart rate and rate\u2013pressure product at the ischemic threshold during exercise. In the group of patients treated with nifedipine no significant improvement was observed in exercise tolerance or in number of ischemic episodes\/24 h. Moreover, the subset of nonresponders in the two methods was larger than in the other two groups. In some of these patients a clearcut worsening of total ischemic load was observed, despite the control of symptoms. This adverse effect might be attributed to the different consequences of the vasodilatory effect of nifedipine on blood flow through stenosed vessels.<\/jats:p>","DOI":"10.1002\/clc.4960150209","type":"journal-article","created":{"date-parts":[[2009,2,4]],"date-time":"2009-02-04T12:29:11Z","timestamp":1233750551000},"page":"98-102","source":"Crossref","is-referenced-by-count":4,"title":["Paradoxical effect of long\u2010term treatment of nifedipine on total ischemic load in patients with stable angina pectoris"],"prefix":"10.1002","volume":"15","author":[{"given":"Maria","family":"Radice","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vittorio","family":"Giudici","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Albertini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Mannarini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,2,4]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(84)90674-X"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(88)90550-9"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.289.6450.951"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.57.6.505"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(80)90361-7"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.66.1.23"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.93.3.485"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(84)90458-2"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(83)90081-9"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(86)90604-1"},{"key":"e_1_2_1_12_2","first-page":"140","article-title":"Comparative pharmacology of calcium antagonists: Nifedipine, verapamil and diltiazem","volume":"114","author":"Henry PD","year":"1980","journal-title":"Am J Cardiol"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02455985"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.74.1.72"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0167-5273(85)90027-0"},{"key":"e_1_2_1_16_2","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1016\/S0733-8651(18)30582-4","article-title":"Detection of silent myocardial ischemia in patients with angina using continuous electrocardiographic monitoring","volume":"4","author":"Pepine CJ","year":"1986","journal-title":"Cardiol Clin"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.6177.1540"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.77.4.774"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01905946"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.42.2.193"},{"key":"e_1_2_1_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.70.6.917"},{"key":"e_1_2_1_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(85)91169-5"},{"key":"e_1_2_1_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(83)80037-0"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fclc.4960150209","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.4960150209","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T10:07:49Z","timestamp":1698055669000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.4960150209"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1992,2]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[1992,2]]}},"alternative-id":["10.1002\/clc.4960150209"],"URL":"https:\/\/doi.org\/10.1002\/clc.4960150209","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[1992,2]]}}}