[Propranolol treatment of effort angina in patients with arterial hypotension].
OBJECTIVE
To compare antianginal efficacy and tolerability of propranolol therapy in patients with stable angina pectoris and chronic hypotension (Hpts) and normotensive patients with angina of effort (Npts).


METHODS
A randomized, single-blind, placebo-controlled study was made in 35 Hpts and 38 Npts was made using bicycle exercise tests, echocardiography, stress myocardial scintigraphy with 77-199.


RESULTS
Acute bicycle exercise tests showed high anti-ischemic activity of propranolol in 86% Hpts and 65% Npts. Stable antianginal propranolol effect in 57% Hpts was accompanied with a decrease of myocardial perfusion defect. Secondary resistance or pseudotolerance to an antianginal effect of propranolol was observed in 43% Hpts in 4-12 weeks (vs 0 of Npts; p < 0.01) as evidenced by T-199 stress myocardial scintigraphy. Hpts with secondary resistance and pseudotolerance to propranolol had lower control hypotension and bradicardia (p < 0.05), more anginal attacks (p < 0.001).


CONCLUSIONS
Hpts had rapidly developing secondary resistance and pseudotolerance to propranolol antianginal effect, bad tolerability of the drug.
E M
EM
Idrisova
A A
AA
Boshchenko
N V
NV
Borovkova
A V
AV
Demochko
V I
VI
Chernov
R S
RS
Karpov
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D000787:Angina Pectoris / Q000150:complications / Q000188:drug therapy*; D001794:Blood Pressure / Q000187:drug effects; D004351:Drug Resistance; D004361:Drug Tolerance; D006352:Heart Ventricles / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D007022:Hypotension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011433:Propranolol / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D016037:Single-Blind Method
D000319:Adrenergic beta-Antagonists; D011433:Propranolol