ACTION study: efficacy of nifedipine in preventing cardiovascular disease in patients with coronary artery disease

Recent reports show that nifedipine not only causes vasodilation but also exerts beneficial effects on the endothelium of blood vessels. Some clinical trials evaluated nifedipine GITS (gastrointestinal therapeutic system) in patients with coronary artery disease. The investigators found that the treatment with nifedipine improved acetylcholine reactivity in coronary arteries and inhibited increases in coronary plaque volume. Furthermore, the large randomised, double-blind, placebo-controlled ACTION (A Coronary Disease Trial Investigating Outcome with Nifedipine GITS) study in patients with stable angina pectoris revealed that the treatment with nifedipine GITS led to significant reductions in the onset of overt heart failure and in the need for coronary angiography or coronary artery bypass graft surgery. These data indicate that a direct action on blood vessels, rather than coronary vasodilating or antihypertensive effects, might be responsible for improved prognosis with nifedipine.