The Effect of the Calcium‐entry Blocker Nifedipine on Cold‐induced Digital Vasospasm

Nilsson H, Jonason T, Leppert J, Ringqvist I (Department of Internal Medicine, Fagersta Hospital, Fagersta, Department of Clinical Physiology, Västerås Central Hospital, Västerås, Department of General Medicine, Västerås Western Hospital, Västerås and Department of Clinical Physiology, Västerås Central Hospital, Västerås, Sweden). The effect of the calcium‐entry blocker nifedipine on cold‐induced digital vasospasm. A double‐blind crossover study versus placebo. Acta Med Scand 1987; 221:53–60. The effects of the calcium‐entry blocker nifedipine 20 mg, two 10 mg capsules, t.i.d. in patients with cold‐induced digital vasospastic disease of idiopathic or traumatic origin was tested in 28 patients, using double‐blind crossover technique on both symptoms and test results. The effect of treatment on digital blood pressure during local cooling was assessed using the Nielsen‐Lassen method. Symptomatic improvement was reported by 5 patients during placebo treatment and 17 during nifedipine treatment (p<0.01). The symptomatic improvement was significant in the total group of patients and in the group of patients with idiopathic vasospastic disease. The digital blood pressure during local cooling improved significantly with nifedipine at 5, 10, 15 (p<0.001) and 20°C (p<0.05) for the total study population and for the two subgroups except for the change at 20°C in the IDIOP group. At a digital temperature of 10°C, 2 patients reached normal digital blood pressure during placebo treatment compared to 16 during nifedipine treatment (p<0.001). The number of side‐effects increased significantly (p<0.05) during nifedipine treatment. We consider the use of nifedipine in patients with cold‐induced digital vasospastic disease to be of great value, especially in patients with digital vasospastic disease of idiopathic origin.