Alprenolol Treatment of Angina Pectoris

To the Editor.— Kerber and associates have written inThe Journal(214:1849-1854, 1970) that they found alprenolol hydrochloride (Aptine), a new β-adrenergic blocking agent, to be generally effective in treatment of various supraventricular arrhythmias and possibly superior to propranolol hydrochloride because alprenolol seems to lack the former drug's negative inotropic effect. We recently reported on the use of alprenolol in 20 patients with angina pectoris.1We conducted a study in which the patients received in turn placebo, 200, and 400 mg of alprenolol hydrochloride per day by random double-blind crossover assignment. Only one patient had to discontinue the drug because of increased dyspnea even though seven patients were receiving digitalis, and six were receiving diuretics as well for treatment of congestive heart failure. Although the drug was well tolerated (only one other patient had to be dropped from the study because of side effects) most of our patients showed