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A Comparison of Carvedilol with a Combination of Propranolol and Isosorbide Dinitrate in the Chronic Treatment of Stable Angina

1992; Lippincott Williams & Wilkins; Volume: 19; Issue: Supplement 1 Linguagem: Inglês

10.1097/00005344-199219001-00022

1533-4023

Wiebke Nahrendorf, A Rading, G Steinig, R. van der Does, A. Schlote,

Hormonal Regulation and Hypertension

Summary: The β-blocking and vasodilating agent carvedilol was compared with a combination of propranolol and isosorbide dinitrate (ISDN) in a double-blind, parallelgroup study. After two baseline sitting bicycle exercise tests on placebo, 31 patients with chronic stable angina were asymmetrically randomized to treatment with carvedilol (25 mg b.i.d.) or propranolol-ISDN (80 mg/20 mg b.i.d.) for a period of 6 months. Further exercise tests were performed 2 h after the first dose as well as after 1, 3, and 6 months of treatment. Twenty-seven patients were considered evaluable for efficacy. Differences between the two groups were observed with emphasis on total exercise time and time to 1-mm ST-segment depression. In contrast to a greater peak effect of the first propranolol/ISDN dose, the chronic antianginal and anti-ischemic effects of carvedilol at trough were found to be more marked than those of the combination.