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Dissociation between clinical and exercise responsiveness to beta-blockade in angina
International Journal of Clinical Pharmacology and Biopharmacy
|November 1, 1978
Summary
Acebutolol significantly reduced angina attack frequency by 71% and increased exercise duration by 56% in patients with mild angina. This cardioselective beta-blocker demonstrated effectiveness even when exercise tolerance did not significantly improve.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Angina pectoris is a common condition characterized by chest pain due to reduced blood flow to the heart.
- Effective management of mild angina is crucial for improving patient quality of life and preventing cardiovascular events.
Purpose of the Study:
- To evaluate the efficacy of acebutolol in patients with mild angina.
- To assess the impact of acebutolol on anginal attack frequency and exercise tolerance.
Main Methods:
- A single-blind study involving 20 outpatients with mild angina.
- Patients received placebo for 7 weeks, followed by acebutolol (200 mg b.i.d.) for 21 weeks.
- Evaluations included daily angina diaries and graded multistage treadmill tests.
Main Results:
- Acebutolol reduced weekly anginal attack frequency by 71% (p<0.05) and increased treadmill exercise duration by 56% (p<0.001).
- 79% of patients experienced a satisfactory clinical response (≥50% reduction in attack frequency).
- Improved exercise duration was strongly predicted by baseline exercise duration (r=0.91, p<0.0005).
Conclusions:
- Acebutolol, at 400 mg/day, substantially reduces anginal attack frequency in patients with mild angina.
- The drug is effective even in patients whose exercise tolerance is not significantly improved.
- Baseline exercise tolerance is a key predictor of response to acebutolol therapy.