Aim: 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).
Material And 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).
Conclusion: Hpts had rapidly developing secondary resistance and pseudotolerance to propranolol antianginal effect, bad tolerability of the drug.
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