The daily ECG monitoring was used in 20 patients with stable functional class II-III angina pectoris to study the antianginal and anti-ischemic effects of verapamil and nifedipine during the cross use of the drugs. Verapamil and nifedipine applied in the effective doses provoked a significant decrease of the number and total depth of painful depressions of the ST segment. The effect of verapamil on painful episodes of ST segment depressions was significantly more pronounced than that of nifedipine. At the same time nifedipine significantly reduced the number and total depth of painless episodes of myocardial ischemia whereas verapamil did not cause any significant lowering of these indicators. In cases where the drugs appeared ineffective, verapamil provoked a significant increase of the number of painless episodes of myocardial ischemia. This indicates that the painful threshold of sensitivity may change with the occurrence of myocardial ischemia in patients suffering from angina pectoris. In turn, nifedipine produced no significant effect on the number and intensity of painless episodes of myocardial ischemia.
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