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Effect of atenolol on treadmill performance in patients with angina pectoris
Insights
Atenolol effectively treats exertional angina pectoris by improving exercise tolerance. This beta-blocker, taken once daily, significantly reduces chest pain and enhances physical performance in patients with coronary artery disease.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Exertional angina pectoris is a common manifestation of coronary artery disease.
- Effective management of angina is crucial for improving patient quality of life and preventing adverse cardiovascular events.
Purpose of the Study:
- To evaluate the efficacy and safety of atenolol in patients with exertional angina pectoris.
- To determine the optimal once-daily dosage of atenolol for managing exercise-induced angina.
Main Methods:
- A single-blind, increasing dose study involving 16 patients with documented coronary artery disease.
- Patients received escalating doses of atenolol (25, 50, 100, and 200 mg once daily) after a placebo period.
- Antianginal efficacy was assessed by treadmill exercise testing at 3 and 24 hours post-administration, monitoring exercise duration, work performed, heart rate, and double product.
Main Results:
- Atenolol significantly prolonged exercise duration and increased work performed at all tested doses and time points (3 and 24 hours).
- Heart rate and double product at exercise endpoint were reduced with atenolol treatment.
- A dose-dependent improvement in exercise tolerance was observed, with the 200 mg dose showing the most substantial increase in exercise duration and work performed (65.4% and 84.8%, respectively).
Conclusions:
- Once-daily atenolol is an effective therapeutic option for patients suffering from exercise-induced angina pectoris.
- The study demonstrated good patient acceptance and compliance with the atenolol regimen.
- Atenolol treatment leads to significant improvements in exercise capacity and reduction in anginal symptoms.
Abstract:
The efficacy and safety of atenolol was evaluated in 16 patients with exertional angina pectoris in a single-blind, once daily, increasing dose study. All patients had coronary artery disease documented by previous myocardial infarction, coronary angiography, or an abnormal exercise ECG. After a four-week placebo period, patients received 25, 50, and 100 mg of atenolol once daily during three two-week periods. This was followed by a three-week treatment period with 200 mg of atenolol once daily. The study was concluded with a two to four week posttreatment period. Antianginal efficacy was assessed by monitoring changes in treadmill exercise performance in each patient 3 and 24 hours after the administration of atenolol. The endpoint of the treadmill exercise was mild but definite chest pain. At 3 and 24 hours after all dosages, atenolol significantly prolonged the duration of exercise and increased the work performed. The pulse rate and double product at the endpoint of exercise were lower with all atenolol doses. Overall, at 24 hours after the administration of atenolol, exercise tolerance was progressively increased as the dose increased. The mean duration of exercise and work performed increased 28.5 and 35.4%, respectively, on the 25-mg dose; 36.9 and 45.5%, respectively, on the 50-mg dose; 45.1 and 59.5%, respectively, on the 100-mg dose; and 65.4 and 84.8%, respectively, on the 200-mg dose. Patient acceptance and compliance were good. Single daily doses of atenolol constitute effective therapy for exercise-induced angina.