Why the study?
Do different doses (80, 160, and 320 mg) of slow-release propranolol have differing effects on exercise duration and angina symptoms in patients with stable angina pectoris?
Do different doses (80, 160, and 320 mg) of slow-release propranolol have differing effects on exercise duration and angina symptoms in patients with stable angina pectoris?
Due to high inter-patient variability, slow-release propranolol doses should be individually titrated for stable angina, as higher doses may cause clinical deterioration in some patients.
Unpredictable responses to slow-release propranolol doses in stable angina support individualized assessment; leaves open optimal dosing strategies.
Doses of 80, 160 and 320 mg of Inderal LA (slow-release propranolol) were compared in 12 patients with stable angina pectoris. There was an unpredictable and variable individual response to treatment and hence no differences were detected between the effects of the three doses on mean treadmill exercise duration, time to angina, frequency of angina or glyceryl/trinitrate consumption. There was a marked deterioration in two patients whilst on 320 mg Inderal LA. In these patients, the time to angina fell by 2 minutes 50 seconds and 4 minutes 20 seconds on 320 mg daily and 160 mg daily respectively. Given the inter-patient variability in response to Inderal LA, the dose for each patient should be individually titrated according to response. Two patients reported here suggest that some subjects may benefit from lower doses, although further work is required to clarify this point. Possible explanations for this finding are discussed.
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Odemuyiwa et al. (1990) studied this question.
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