Efficacy of acebutolol in chronic stable angina using single-blind and randomized double-blind protocol

The clinical effects of a cardioselective beta-adrenergic blocking drug, acebutolol, were studied in 25 patients with chronic stable angina, using a seven-week single-blind placebo leads to acebutolol (mean dose 913 mg/day) phase followed by 12-week randomized double-blind placebo leads to acebutolol (mean dose 968 mg/day) crossover protocol. Objective parameters from exercise treadmill tests showed consistent reduction in resting and maximal exercise heart rate and rate-pressure product during both single- and double-blind phases. Duration of exercise and maximal ST segment depression were not significantly altered. Subjective improvement following acebutolol was observed with reduced frequency of anginal attacks and nitroglycerin consumption during the single-blind phase. However, no differences were seen during the double-blind phase due to significant subjective improvement during the latter placebo period. Adverse effects observed were mild in nature and were similar to those seen with other beta blockers. These data establish acebutolol as a potent beta-blocking agent and emphasize the importance of utilizing objective parameters over subjective variables in demonstrating the clinical antianginal efficacy of a beta blocker.