Randomised, double-blind, three-way cross-over study of dilevalol 200 and 400 mg and atenolol 100 mg once-daily in patients with chronic stable angina pectoris

Abstract

Eighteen male patients (aged 40-66 years) with confirmed ischaemic heart disease and a minimum of four angina attacks per week were included in a double-blind comparison of dilevalol 200 mg, dilevalol 400 mg and atenolol 100 mg. Following a one-week placebo run-in period patients were randomly allocated to one of the three treatments, after which they crossed to the remaining two treatments according to a balanced Latin square design. Each treatment was given once-daily over four weeks. Symptom-limited treadmill exercise testing using a modified Bruce protocol was performed at the end of placebo, and after each treatment around 24 hours post-dosing. The mean exercise time on placebo was 7.0 (+/- 0.91) minutes which changed to 7.8 (+/- 0.93) minutes on dilevalol 200 mg, 7.3 (+/- 0.88) minutes on dilevalol 400 mg and 8.2 minutes (+/- 1.06) on atenolol 100 mg. Nine patients had a greater exercise tolerance on dilevalol (200 or 400 mg), and nine a greater exercise tolerance on atenolol. Maximum exercise heart rate on placebo was 113 (+/- 5.0) beats per minute (bpm) which was reduced to 101 (+/- 3.6), 96 (+/- 2.7) and 98 (+/- 4.9) bpm. on dilevalol 200 mg, dilevalol 400 mg and atenolol 100 mg, respectively. Correspondingly, the rate-pressure product was reduced from 18.1 (x 10(3)) units on placebo to 14.8, 13.4 and 14.4 (x 10(3)) units on each treatment. Pairwise comparisons by the least square mean procedure showed no significant differences between treatments for any of the measured parameters. All treatments caused a reduction in both angina attack rates and trinitrate consumption.(ABSTRACT TRUNCATED AT 250 WORDS)