Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

1. Eight hypertensive patients with angina pectoris had placebo added to their existing medications for 8 weeks, then incremental doses of active labetalol with simultaneous stepwise reduction in other medicines until blood pressure was satisfactorily controlled; after that only labetalol and thiazide (8 weeks) and finally labetalol-placebo together with previous beta-adrenoreceptor antagonists and thiazide for 4 weeks were administered. 2. During the labetalol plus thiazide period resting blood pressures and measurements obtained during isotonic exercise, isometric exercise and the cold pressor test were significantly lower than during the initial placebo addition period. Angina scores were significantly reduced during this period. 3. During the final treatment with placebo, beta-adrenoreceptor antagonist and thiazide, blood pressures remained reduced, but angina was significantly worse. 4. Labetalol which antagonizes both alpha- and beta-adrenoreceptors produced better relief of angina pectoris than beta-adrenoreceptor antagonists during improvement in blood pressure in hypertensive patients.
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PMID:Labetalol in hypertensive patients with angina pectoris: beneficial effect of combined alpha- and beta-adrenoreceptor blockade. 3 6

1 In nine hypertensive subjects with angina pectoris, labetalol diminished the incidence of chest pain occurring spontaneously or induced by exercise. 2 Labetalol lowered BP in all subjects. 3 Exercise tolerance at maximum levels was increased by labetalol. 4 Improved cardiac function by labetalol may be related to decreased afterload on the left ventricle, and diminished oxygen utilization by the myocardium.
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PMID:Open evaluation of labetalol in the treatment of angina pectoris occurring in hypertensive patients. 52 2

The various antihypertensive agents reduce blood pressure by different mechanisms. Alpha-1 receptor blockers reduce vascular resistance and maintain cardiac output. Chronic treatment with beta blockers without intrinsic sympathomimetic activity produces a fall in blood pressure which is associated with a fall in cardiac index and heart rate. Beta blockers with strong intrinsic sympathomimetic activity showed reduced heart rate during exercise. Labetalol reduces cardiac output and peripheral vascular resistance with little or no reduction in peripheral blood flow. Alpha-1 blockers are suitable for patients with active life-styles, with peripheral vascular disorders, or with high blood-cholesterol levels. Beta blockers are useful in patients who have tachycardia, palpitation problems, or angina pectoris, or who have survived a heart attack. They should not be used in patients with bronchial asthma, reduced peripheral blood flow, or heart failure. Labetalol reduces blood pressure in a somewhat larger fraction of patients than the pure alpha- or beta-blocking agents. It is hoped that its long-term results will include regression of cardiovascular damage, improved quality of life, and increased life expectancy.
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PMID:The hemodynamic effects of adrenergic blocking agents. 135 Feb 35

The acute hemodynamic responses to beta-adrenoceptor blockade with the beta 1-selective antagonist metoprolol, and to combined alpha/beta-receptor blockade with labetalol, were compared intraindividually in a randomized single-blind, cross-over study. Fourteen patients with proved ischemic heart disease, aged 52-64 years, were studied at rest (supine) and during ischemia-inducing exercise (in the seated posture) using invasive percutaneous techniques. Metoprolol reduced heart rates and cardiac output greatly (p less than 0.001) and systemic arterial pressures slightly (p less than 0.001) under all conditions. Left ventricular filling pressures increased. Labetalol induced a slight decrease in heart rates during exercise, while cardiac output was unchanged. Systemic arterial pressures and vascular resistances, pressures and resistances in the pulmonary circulation, and left ventricular filling pressures were distinctly lower. During ischemia-inducing exercise, the differences between the effects of labetalol and metoprolol on heart rate, cardiac output, systemic vascular resistance, and left ventricular filling pressures were highly significant. The effects on the rate X pressure product and on angina were similar. It is concluded that combined alpha/beta-blockade with labetalol offsets or attenuates the potential adverse hemodynamic effects of beta-receptor blockade alone without loss of symptomatic efficacy.
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PMID:Hemodynamic effects at rest and during exercise of combined alpha/beta-receptor blockade and of beta-receptor blockade alone in patients with ischemic heart disease. 244 2

Labetalol is a non-selective beta-adrenoceptor antagonist agent with added alpha 1-adrenergic blocking properties, beta 2-stimulating action, and direct vasodilatory activity. A multi-center, double-blind, parallel group study compared the safety and efficacy of labetalol to propranolol in the treatment of patients with both exertional angina and mild to moderate systemic hypertension. An initial 4 to 5 week placebo washout phase was followed by a five week titration phase and a four month maintenance phase. Labetalol and propranolol had similar effects in reducing supine and standing blood pressures, except for a greater reduction in standing systolic blood pressure seen in the labetalol group. There were comparable effects by both treatments on angina attacks, nitroglycerin use, and exercise tolerance. Adverse effects were frequent with both drugs, but were generally minor. Thus, labetalol appears to be an effective alternative to propranolol in the treatment of patients with coexisting angina pectoris and hypertension, with the choice of agent dependent on the clinical situation.
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PMID:Labetalol compared with propranolol in patients with both angina pectoris and systemic hypertension: a double-blind study. 266 51

The present review shows that labetalol has many advantageous properties in the treatment of patients suffering from angina pectoris with or without hypertension. These patients respond with vasoconstriction to a variety of internal and external influences. The selective alpha 1-blocking component in addition to the non-selective beta-blockade of labetalol attenuates the increased coronary vascular resistance and improves coronary haemodynamics especially under stress in a manner which should be favourable in myocardial ischaemia. In addition, the alpha 1-blocking component may prevent different kinds of arrhythmias generated by alpha-adrenoceptor stimulation. Labetalol has no effect on renal blood flow, glomerular filtration rate, plasma electrolyte concentrations, glucose tolerance, lipoprotein cholesterol ratio, renin-angiotensin-aldosterone system, uric acid levels, or on platelet aggregation. Intravenously administrated labetalol has proved to be effective in patients with acute myocardial infarction, especially if associated with hypertension. In order to avoid postural hypotension, oral treatment should be started with a low dose of 100 mg twice daily. The usual dosage in patients without hypertension is 200 mg twice daily, but in patients with hypertension doses up to 1200 mg or even more have been used. In low doses up to 400 mg daily, the unwanted effects are few and often self-limited. High doses can cause side effects related to both beta- and alpha-blocking properties of labetalol. As an antianginal agent labetalol has proved to be at least as effective as selective or non-selective beta-blockers.
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PMID:Labetalol in the treatment of angina pectoris. 288 99

Labetalol, a combined alpha-beta-adrenergic antagonist, is one of the new group of beta-adrenergic blockers reduces peripheral and coronary vascular resistances while preserving cardiac output. Unlike alpha-adrenergic blockers, labetalol tends to reduce heart rate during rest and exercise. The drug is a potent antihypertensive agent which has been used by mouth and by vein to treat mild, moderate, and severe hypertension, including hypertensive emergencies. Labetalol has a hemodynamic profile which makes it an attractive agent for treating myocardial ischemia. The drug reduces blood pressure, left ventricular wall tension, heart rate, and contractility while preserving or even augmenting coronary blood flow. Studies with labetalol in hypertensive patients with angina have shown it to be more effective than placebo in reducing angina attacks and blood pressure while improving exercise tolerance. The drug appears to have antianginal and antihypertensive effects comparable to atenolol and propranolol. Side effects of treatment are observed and most are related to alpha- and beta-adrenergic blockade. Labetalol also appears to be effective for treatment of normotensive patients with angina and for silent myocardial ischemia. It has no apparent effects on serum lipids and lipoproteins. Labetalol appears to be a useful drug for treating the hypertensive heart and its many complications.
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PMID:Properties of labetalol, a combined alpha- and beta-blocking agent, relevant to the treatment of myocardial ischemia. 290 32

Intravenous labetalol was evaluated in 10 patients with stable angina without heart failure. Mean dose was 1.75 mg/kg (range 1.5-2 mg/kg). Measurements were taken within one minute after the injection, and at 1, 5 and 15 minutes thereafter. Labetalol significantly decreased blood pressure and increased heart rate. Peak aortic flow velocity increased only significantly at 1 minute; dP/dt+ max. was significantly decreased during all the measurements. Left ventricular end diastolic pressure did not change. Thus in patients without failure left ventricular function remained stable despite the negative inotropic effects of labetalol.
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PMID:Evaluation of the alpha and beta blocking effects of intravenous labetalol on left ventricular function in coronary artery disease. 299 29

Labetalol, a combined alpha- and beta-receptor antagonist, was compared with nifedipine in a placebo-controlled, randomized double-blind cross over study (four week treatment periods) of 11 normotensive patients with stable exertional angina pectoris. Standard recommended doses of both drugs (labetalol 200-400 mg twice daily, nifedipine 10-20 mg three times daily) were used. Angina frequency was similar during the placebo washout period and treatment with the two drugs. The duration of treadmill exercise to angina, ischaemia (greater than 1 mm ST segment depression), and end of exercise was increased by both labetalol and nifedipine when compared with placebo, but there was no difference between the two drugs. Ambulatory ST segment monitoring demonstrated that the frequency, duration and magnitude of ST segment depression, whether painful or silent, were unaffected by either drug. Labetalol is an effective agent in improving exercise tolerance in normotensive patients with stable exertional angina pectoris, with an efficacy similar to that of nifedipine.
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PMID:Labetalol in the treatment of stable exertional angina pectoris: a comparison with nifedipine. 306 66

Labetalol, an alpha-beta-blocker, has been shown to have vasodilating as well as beta-blocking properties. From the theoretical point of view such a drug is likely to be beneficial in the treatment of angina pectoris. There are very few studies investigating the effects of labetalol in normotensive patients with angina pectoris. The three major controlled trials that have been published show that labetalol reduces angina frequency and prolongs exercise duration. In one study the effects of labetalol in anginal subjects using ambulatory monitoring was performed and showed a reduction in silent ischemia as well as a reduction in angina pectoris. Thus labetalol would appear to be an effective antianginal agent. Further studies are necessary to determine if the anti-anginal effect is entirely due to the beta-receptor-blocking activity of the drug or whether labetalol's vasodilating property has important additional benefit.
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PMID:Labetalol in normotensive patients with angina pectoris. 315 18


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