This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Winniford, M. D. Articles by Hillis, L. D. Search for Related Content PubMed PubMed Citation Articles by Winniford, M. D. Articles by Hillis, L. D. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB PRAZOSIN HYDROCHLORIDE

Circulation, Vol 67, 1185-1188, Copyright © 1983 by American Heart Association

ARTICLES

Alpha-adrenergic blockade for variant angina: a long-term, double- blind, randomized trial

MD Winniford, N Filipchuk and LD Hillis

Recent reports have shown that beta-adrenergic blockade may exacerbate variant angina. On theoretical grounds, alpha-adrenergic blockade may be beneficial in these patients. To test this hypothesis, we assessed the efficacy of prazosin, an alpha-adrenergic blocking agent, in six men, mean age 49 years, with variant angina. Prazosin, 14.0 +/- 2.4 mg/day (mean +/- SD) in three equal doses, was compared with placebo in a double-blind, randomized, double-crossover trial lasting 4 1/2 months: 2 weeks of open-label prazosin followed by four 1-month periods of blinded alternating therapy. No other vasoactive medications were administered during the study. Prazosin reduced sitting systolic arterial pressure from 145 +/- 18 to 127 +/- 16 mm Hg (p = 0.02), but exerted no effect on diastolic arterial pressure or heart rate. Prazosin did not change the weekly number of episodes of chest pain (2.5 +/- 2.3 with placebo vs 3.1 +/- 3.0 with prazosin, NS), nitroglycerin tablets used (3.9 +/- 3.7 with placebo vs 4.6 +/- 4.2 with prazosin, NS), or transient ST-segment deviations (by calibrated two-channel Holter monitoring for 24 hours/week throughout the study) (6.5 +/- 10.1 with placebo vs 11.8 +/- 17.4 with prazosin, NS). During prazosin therapy, three patients had orthostatic dizziness and one patient had headache. Thus, in a long-term, randomized, double-blind trial, prazosin exerted no obvious beneficial effect in patients with variant angina.

This article has been cited by other articles:

				P. K. Mishra Variations in presentation and various options in management of variant angina. Eur. J. Cardiothorac. Surg., May 1, 2006; 29(5): 748 - 759. [Abstract] [Full Text] [PDF]

				S. Salvi Protecting the Myocardium From Ischemic Injury : A Critical Role for {{alpha}}1-Adrenoreceptors? Chest, April 1, 2001; 119(4): 1242 - 1249. [Abstract] [Full Text] [PDF]

				G. Heusch, D. Baumgart, P. Camici, W. Chilian, L. Gregorini, O. Hess, C. Indolfi, and O. Rimoldi {alpha}-Adrenergic Coronary Vasoconstriction and Myocardial Ischemia in Humans Circulation, February 15, 2000; 101(6): 689 - 694. [Abstract] [Full Text] [PDF]

				Y. Aizawa, S. Niwano, M. Aizawa, M. Tamura, and A. Shibata Attenuation of the Vasoconstrictor Action of Neuropeptide-Y by Calcium-Channel Blockers Angiology, October 1, 1989; 40(10): 890 - 894. [Abstract] [PDF]

				C. R. Conti, J. A. Hill, R. L. Feldman, J. L. Mehta, and C. J. Pepine Analytic Review: Treatment of Coronary Artery Spasm and Variant Angina J Intensive Care Med, March 1, 1986; 1(2): 66 - 74. [Abstract] [PDF]