[JMIC-B study and its sub-analyses: effect of nifedipine in Japanese hypertensive patients with coronary artery disease].

It is thought that coronary artery spasm is involved in the pathogenesis of coronary artery disease in a large proportion of Japanese patients. However, large-scale trial data in Japanese patients were lacking. The JMIC-B (Japan Multicenter Investigation for Cardiovascular Diseases-B) study conducted for Japanese hypertensive patients with coronary artery disease, compared the incidence of cardiac events (cardiac death or sudden death, myocardial infarction, hospitalization for angina pectoris or heart failure, serious arrhythmia, and coronary interventions) in patients receiving twice-daily nifedipine or an angiotensin-converting enzyme (ACE) inhibitor (enalapril, lisinopril or imidapril). There was a similar incidence of cardiac events in both treatment groups but exacerbation of angina pectoris in patients with a history of myocardial infarction was lower with nifedipine. Nifedipine appeared to be better than ACE inhibitor in inhibiting the progression of coronary atherosclerosis and the development of coronary artery stenosis as evidenced by quantitative coronary angiogram (QCA) analysis.