Alpha-adrenergic blockade for variant angina

A long-term double-blind randomized trial

M. D. Winniford, N. Fipichuk, L. D. Hillis

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Recent reports have shown that β-adrenergic blockade may exacerbate variant angina. On theoretical grounds, α-adrenergic blockade may be beneficial in these patients. To test this hypothesis, we assessed the efficacy of prazosin, an α-adrenergic blocking agent, in six men, mean age 49 years, with variant angina. Prazosin, 14.0 ± 2.4 mg/day (mean ± SD) in three equal doses, was compared with placebo in a double-blind, randomized, double-crossover trial lasting 4 1/2 months; 2 weeks of open-label prazosin followed by four 1-month periods of blinded alternating therapy. No other vasoactive medications were administered during the study. Prazosin reduced sitting systolic arterial pressure from 145 ± 18 to 127 ± 16 mm Hg (p = 0.02), but exerted no effect on diastolic arterial pressure or heart rate. Prazosin did not change the weekly number of episodes of chest pain (2.5 ± 2.3 with placebo vs 3.1 ± 3.0 with prazosin, NS), nitroglycerin tablets used (3.9 ± 3.7 with placebo vs 4.6 ± 4.2 with prazosin, NS) or transient ST-segment deviations (by calibrated two-channel Holter monitoring for 24 hours/week throughout the study) (6.5 ± 10.1 with placebo vs 11.8 ± 17.4 with prazosin, NS). During prazosin therapy, three patients had orthostatic dizziness and one patient had headache. Thus, in a long-term, randomized, double-blind trial, prazosin exerted no obvious beneficial effect in patients with variant angina.

Original languageEnglish (US)
Pages (from-to)1185-1188
Number of pages4
JournalCirculation
Volume67
Issue number6 I
StatePublished - 1983
Externally publishedYes

Fingerprint

Prazosin
Adrenergic Agents
Placebos
Arterial Pressure
Blood Pressure
Ambulatory Electrocardiography
Adrenergic Antagonists
Nitroglycerin
Dizziness
Chest Pain
Cross-Over Studies
Tablets
Headache
Heart Rate

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Winniford, M. D., Fipichuk, N., & Hillis, L. D. (1983). Alpha-adrenergic blockade for variant angina: A long-term double-blind randomized trial. Circulation, 67(6 I), 1185-1188.

Alpha-adrenergic blockade for variant angina : A long-term double-blind randomized trial. / Winniford, M. D.; Fipichuk, N.; Hillis, L. D.

In: Circulation, Vol. 67, No. 6 I, 1983, p. 1185-1188.

Research output: Contribution to journalArticle

Winniford, MD, Fipichuk, N & Hillis, LD 1983, 'Alpha-adrenergic blockade for variant angina: A long-term double-blind randomized trial', Circulation, vol. 67, no. 6 I, pp. 1185-1188.
Winniford, M. D. ; Fipichuk, N. ; Hillis, L. D. / Alpha-adrenergic blockade for variant angina : A long-term double-blind randomized trial. In: Circulation. 1983 ; Vol. 67, No. 6 I. pp. 1185-1188.
@article{cbe5268596cc4ade9b9f92f3b19a7765,
title = "Alpha-adrenergic blockade for variant angina: A long-term double-blind randomized trial",
abstract = "Recent reports have shown that β-adrenergic blockade may exacerbate variant angina. On theoretical grounds, α-adrenergic blockade may be beneficial in these patients. To test this hypothesis, we assessed the efficacy of prazosin, an α-adrenergic blocking agent, in six men, mean age 49 years, with variant angina. Prazosin, 14.0 ± 2.4 mg/day (mean ± SD) in three equal doses, was compared with placebo in a double-blind, randomized, double-crossover trial lasting 4 1/2 months; 2 weeks of open-label prazosin followed by four 1-month periods of blinded alternating therapy. No other vasoactive medications were administered during the study. Prazosin reduced sitting systolic arterial pressure from 145 ± 18 to 127 ± 16 mm Hg (p = 0.02), but exerted no effect on diastolic arterial pressure or heart rate. Prazosin did not change the weekly number of episodes of chest pain (2.5 ± 2.3 with placebo vs 3.1 ± 3.0 with prazosin, NS), nitroglycerin tablets used (3.9 ± 3.7 with placebo vs 4.6 ± 4.2 with prazosin, NS) or transient ST-segment deviations (by calibrated two-channel Holter monitoring for 24 hours/week throughout the study) (6.5 ± 10.1 with placebo vs 11.8 ± 17.4 with prazosin, NS). During prazosin therapy, three patients had orthostatic dizziness and one patient had headache. Thus, in a long-term, randomized, double-blind trial, prazosin exerted no obvious beneficial effect in patients with variant angina.",
author = "Winniford, {M. D.} and N. Fipichuk and Hillis, {L. D.}",
year = "1983",
language = "English (US)",
volume = "67",
pages = "1185--1188",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "6 I",

}

TY - JOUR

T1 - Alpha-adrenergic blockade for variant angina

T2 - A long-term double-blind randomized trial

AU - Winniford, M. D.

AU - Fipichuk, N.

AU - Hillis, L. D.

PY - 1983

Y1 - 1983

N2 - Recent reports have shown that β-adrenergic blockade may exacerbate variant angina. On theoretical grounds, α-adrenergic blockade may be beneficial in these patients. To test this hypothesis, we assessed the efficacy of prazosin, an α-adrenergic blocking agent, in six men, mean age 49 years, with variant angina. Prazosin, 14.0 ± 2.4 mg/day (mean ± SD) in three equal doses, was compared with placebo in a double-blind, randomized, double-crossover trial lasting 4 1/2 months; 2 weeks of open-label prazosin followed by four 1-month periods of blinded alternating therapy. No other vasoactive medications were administered during the study. Prazosin reduced sitting systolic arterial pressure from 145 ± 18 to 127 ± 16 mm Hg (p = 0.02), but exerted no effect on diastolic arterial pressure or heart rate. Prazosin did not change the weekly number of episodes of chest pain (2.5 ± 2.3 with placebo vs 3.1 ± 3.0 with prazosin, NS), nitroglycerin tablets used (3.9 ± 3.7 with placebo vs 4.6 ± 4.2 with prazosin, NS) or transient ST-segment deviations (by calibrated two-channel Holter monitoring for 24 hours/week throughout the study) (6.5 ± 10.1 with placebo vs 11.8 ± 17.4 with prazosin, NS). During prazosin therapy, three patients had orthostatic dizziness and one patient had headache. Thus, in a long-term, randomized, double-blind trial, prazosin exerted no obvious beneficial effect in patients with variant angina.

AB - Recent reports have shown that β-adrenergic blockade may exacerbate variant angina. On theoretical grounds, α-adrenergic blockade may be beneficial in these patients. To test this hypothesis, we assessed the efficacy of prazosin, an α-adrenergic blocking agent, in six men, mean age 49 years, with variant angina. Prazosin, 14.0 ± 2.4 mg/day (mean ± SD) in three equal doses, was compared with placebo in a double-blind, randomized, double-crossover trial lasting 4 1/2 months; 2 weeks of open-label prazosin followed by four 1-month periods of blinded alternating therapy. No other vasoactive medications were administered during the study. Prazosin reduced sitting systolic arterial pressure from 145 ± 18 to 127 ± 16 mm Hg (p = 0.02), but exerted no effect on diastolic arterial pressure or heart rate. Prazosin did not change the weekly number of episodes of chest pain (2.5 ± 2.3 with placebo vs 3.1 ± 3.0 with prazosin, NS), nitroglycerin tablets used (3.9 ± 3.7 with placebo vs 4.6 ± 4.2 with prazosin, NS) or transient ST-segment deviations (by calibrated two-channel Holter monitoring for 24 hours/week throughout the study) (6.5 ± 10.1 with placebo vs 11.8 ± 17.4 with prazosin, NS). During prazosin therapy, three patients had orthostatic dizziness and one patient had headache. Thus, in a long-term, randomized, double-blind trial, prazosin exerted no obvious beneficial effect in patients with variant angina.

UR - http://www.scopus.com/inward/record.url?scp=0020630977&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0020630977&partnerID=8YFLogxK

M3 - Article

VL - 67

SP - 1185

EP - 1188

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 6 I

ER -