[Nitrates in therapy of effort angina in hypotensive patients]. / Nitraty v terapii stenokardii napriazheniia u bol'nykh s arterial'noi gipotenziei.

A randomized single blind cross-over trial with placebo lead-in has been conducted in 71 anginal patients with arterial hypotension (group 1) and 38 ischemic heart disease patients with normal arterial pressure (group 2) to compare efficacy of therapy with isosorbide dinitrate (ID), sustac-forte (SF), isosorbide dinitrate retard (IDR) and trinitrolong (TN). Paired bicycle exercises revealed that in group 1 patients ID was low effective in 49%, SF--in 61%, IDR was highly effective in 97% and TN--in 96%. In group 1 tolerance to antianginal effect of ID, SF and IDR shown by stress myocardial scintigraphy with Tl-199 developed earlier--in 2-4 weeks in 63-70% patients (versus 22-27% in group 2; p < 0.01). Recovery of ID, SF, IDR effect required prolongation of the drug withdrawal period to 8-16 days (versus 3-5 days in group 2; p < 0.05). TN therapy remained effective for 3 months. Resistance to ID, SF in group 1 was relative and depended on dosage form of nitrates.

[Long-acting isosorbide dinitrate and molsidomin in the treatment of effort angina in patients with arterial hypotension]. / Izosorbida dinitrat i molsidomin prolongirovannogo deistviia pri lechenii stenokardii napriazheniia u bol'nykh s arterial'noi gipotoniei.

AIM: To compare effectiveness and tolerance of isosorbide dinitrate (ID) and molsidomin in retard forms in patients with effort angina (EA) in combination with arterial hypotension (AH). MATERIAL AND METHODS: A randomised blind cross-over trial with lead-in placebo period trial compared efficiency of retard ID and molsidomin in 65 EA patients with AH (group 1) and 40 normotensive patients with coronary heart disease (group 2). RESULTS: Bicycle exercise has shown that retard ID and molsidomin retard were highly effective in group 1 (97% vs 92% 0 and group 2 (100 and 95%, respectively). Molsidomin retard treatment improved myocardial perfusion and was effective for a year in both groups. CONCLUSION: Retard ID was highly effective in anginal patients with AH but its tolerance is also high. Molsidomin retard is proposed as alternative treatment in anginal patients with AH.