Comparison of the duration of action of atenolol and nadolol for treatment of angina pectoris.
In a randomized, double-blind, placebo-controlled cross-over study, 16 patients with angina on effort due to proven coronary artery disease were given atenolol 50 or 100 mg and nadolol 40 or 80 mg every morning. Compared with placebo control, both beta blockers equally decreased angina frequency, suppressed supine, standing, submaximum and maximum heart rates and double products (all p less than 0.0001) and increased exercise tolerance (p less than 0.01) when the exercise stress test was done 3 to 4 hours after the daily dose. When the exercise stress test was done 24 hours after the daily dose, the suppression of resting and maximum exercise heart rates and maximum double product was more pronounced by nadolol than atenolol (p less than 0.05). Ambulatory electrocardiography heart rates were also equally suppressed by both beta blockers in the afternoon, evening and nighttime hours. However, in the hours just before and just after the ingestion of the daily dose the effect of nadolol (elimination half-life 1,436 +/- 420 minutes) was more pronounced (p less than 0.05) than that of atenolol (half-life 537 +/- 62 minutes). Negative correlations (p less than 0.03) between beta-blocker blood levels and submaximal exercise heart rates and double products were observed.
Kostis
J B
JB
Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick 08903-0019.
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy*; D001262:Atenolol / Q000008:administration & dosage / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005080:Exercise Test; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009248:Nadolol / Q000008:administration & dosage / Q000627:therapeutic use*; D010919:Placebos; D011897:Random Allocation; D013997:Time Factors
D010919:Placebos; D009248:Nadolol; D001262:Atenolol