Regular attacks of chest pain induced by exercise (angina pectoris) is a common condition caused by blockages of the blood vessels that supply the heart (coronary heart disease).
This condition may develop without warning but often occurs in patients who have had a heart attack. One of the most commonly prescribed drugs to reduce attacks of chest pain is nifedipine, a calcium channel blocker. Because this drug also reduces blood pressure, it is frequently prescribed to people whose blood pressure is too high. Dr. Curt Furberg created a considerable commotion at the European Society of Cardiology Congress in 1995 by suggesting that short-acting nifedipine in particular and other drugs from the same class are unsafe and should not be used in patients with coronary heart disease or elevated blood pressure.
Directly after Dr. Furberg’s 1995 presentation, SOCAR Research (an independent research institute that has large experience in clinical studies with nifedipine and other compounds in cardiac patients) proposed to Bayer (the manufacturer of nifedipine) to respond in a scientifically convincing manner by mounting the first-ever clinical trial in patients with stable angina pectoris that is large enough to assess the effect of nifedipine on important clinical events such as death, heart attacks, stroke and heart failure. The proposed trial became known as the ACTION study and compared the long-acting GITS (gastrointestinal therapeutic system) formulation of nifedipine with placebo. This is important because Dr. Furberg’s data came from studies using the less optimal, short-acting formulation.
With the support of Bayer, the ACTION study has now been completed by SOCAR Research in collaboration with an international group of robustly independent experts chaired by Professor Philip A. Poole-Wilson from Imperial College, London, UK. Professor Poole.
Nine years after Dr. Furberg’s presentation, and after studying just under 8,000 patients for a maximum of 6 years – half of whom were treated with nifedipine GITS and half with placebo – the place of this medication in the treatment of patients with stable angina can now be defined reliably as follows: