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Biomedical subjects

M B Comerford

Publications and source records attributed to M B Comerford.

13 recordsLinked to original sources
PubMed1991

The relationship between exercise tolerance and quality of life in angina pectoris.

The relationship between exercise tolerance assessed by a conventional exercise stress test using a standard Bruce protocol and quality of life (QoL) was studied in 50 patients with stable angina pectoris (AP). Before the exercise test, patients completed three self-administered QoL questionnaires, the Psychological General Well-Being Index, an Angina-Specific QoL Questionnaire, and Jenkins' Sleep Dysfunction Scale. Total exercise time (r = -0.40) and time until onset of pain (r = -0.44) were significantly correlated with perceived physical limitations. Somatic symptoms were related to total time (r = -0.38). Apart from a significant correlation between depressed mood and total exercise time (r = 0.36), there was no corresponding correlation with well-being and sleep disturbance. These results suggest that exercise stress tests do not reflect quality of life in patients with AP.

Activities of Daily Living↗
PubMed1987

Monotherapy with felodipine, a new calcium antagonist, in mild and moderate hypertension.

The role of felodipine, a new calcium antagonist, in monotherapy for mild and moderate hypertension was investigated in a placebo-controlled double-blind study of 109 patients from 13 centres. The patients were randomised in a double-blind fashion to receive felodipine, 2.5 mg b.i.d. (32 patients), 5 mg b.i.d. (30 patients), 10 mg b.i.d. (24 patients), or placebo (23 patients). Two hours after the first tablet was administered, there was a reduction in systolic and diastolic blood pressure, both supine (p less than 0.05) and standing (p less than 0.001), that was significantly correlated with dose. Three and 8 weeks later, 2 h after dosage, this correlation was still apparent in both supine and standing blood pressure (p less than 0.001). One week after randomisation, at 12 hours after administration there was a significant correlation with dose in the standing systolic (p less than 0.05) and diastolic (p less than 0.01) blood pressure. After 8 weeks therapy, a significant correlation with dose occurred in both supine and standing systolic (p less than 0.05) and diastolic (p less than 0.01) blood pressure 12 h after therapy. The proportion of patients completing the study who achieved a supine diastolic blood pressure of 90 mm Hg or less after 8 weeks therapy at 2 h after dosage was 9% on placebo, 67% on felodipine 2.5 mg b.i.d., 57% on felodipine 5 mg b.i.d., and 92% on felodipine 10 mg b.i.d. Felodipine was generally well tolerated although 10 patients on the highest dose withdrew due to adverse experiences. Plasma felodipine levels were significantly correlated with dose.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1984

A dose response study with oral prenalterol in patients with chronic congestive cardiac failure.

Prenalterol is an orally active cardioselective beta agonist, with a long half-life. Previous studies have confirmed its inotropic activity following intravenous infusion in patients with heart failure. It has little chronotropic activity and no significant arrhythmogenicity. We have studied the response to sustained-release oral prenalterol given over four weeks at doses of 20, 40, 100, and 200 mg daily in 10 patients with New York Heart Association class II and III heart failure due to ischemic heart disease. All were in sinus rhythm and already receiving diuretics and digoxin. The drug was well tolerated and without side effects. Nine patients showed a dose-related improvement in their exercise tolerance as measured on the treadmill, up to a dose of 100 mg daily, with a significant increase in estimated oxygen uptake. There was a dose-related reduction in maximum heart rate, systolic blood pressure, and rate-pressure product during exercise, which is suggestive of a reduction in myocardial oxygen consumption. We conclude that prenalterol improves exercise tolerance without any significant cardiovascular or other side effects, and produces a clinically relevant and sustained improvement in patients with chronic heart failure. M-mode echocardiographic measurements of left ventricular dimension and function at rest did not show any change during the study.

Administration, Oral↗
PubMed1982

A clinical evaluation of sustained release metoprolol durules in the treatment of angina pectoris.

A clinical comparison of the sustained release form of metoprolol, consisting of a 200 mg metoprolol durule, with 100 mg conventional metoprolol twice daily, has been carried out to assess the therapeutic control of ten patients with stable angina pectoris. Objective measurements of heart rate, blood pressure, and ECG recordings were assessed during exercise on a bicycle ergometer. Ten patients completed the 8-week double-blind study. There were similar changes in heart rate and blood pressure at rest and during exercise, both at 2 h and at 12 and 24 h postdose. Although similar exercise tolerance was achieved on both regimes, there was significantly less ST-segment depression at 24 h post durule, in comparison with the 12 h post conventional metoprolol reading, suggesting that metoprolol durules produce a more effective reduction in the degree of myocardial ischemia.

Aged↗
PubMed1982

A comparison of the effects of the slow release formulations of metoprolol and oxprenolol in hypertension.

The therapeutic control of blood pressure and heart rate throughout the 24 hour period, was assessed in ten hypertensive patients, following the administration of placebo, conventional metoprolol 100 mg twelve hourly, and the slow release formulations of metoprolol (metoprolol S.A.) and oxprenolol (oxprenolol S.R.), given once daily. Good blood pressure control at rest was observed at two hours post dose following the three drug regimes. Analysis of blood pressure and heart rate values in response to exercise showed no difference between conventional and metoprolol S.A. at either two hours or 12/24 hours post dose. However, at 24 hours, metoprolol S.A. gave better clinical control of the systolic blood pressure and heart rate than oxprenolol S.R. with metoprolol inhibiting exercise induced tachycardia by 29% at 2 hours and 20% at 24 hours (oxprenolol 24% and 11% respectively). In this study, metoprolol S.A. was effective in the control of hypertension throughout the 24 hours period, both at rest and during exercise. The control at 24 hours by oxprenolol S.R. was poor and suggests that the present formulation should be reconsidered.

Adult↗
PubMed1976

An eighteen months' study of the clinical response to metoprolol, a selective beta1-receptor blocking agent, in patients with angina pectoris.

Following an initial dose response study, metoprolol, a selective beta1-receptor blocking agent, was compared with equipotent dosages of propanolol in a double blind cross-over study, including exercise tolerance tests, on fourteen patients with angina pectoris. Long term therapy with metoprolol then followed until the seventy-second week. Patients performed 8% more total work on metoprolol with 15% more work recorded up to the onset of S-T depression, in comparison with propranolol. In the long term, ther was no significant difference in work performed when the daily dosage of metoprolol was changed from a q.i.d. to a b.d. regime. Metoprolol was shown to be an effective anti-anginal compound with good tolerance and safety, with gradual improvement in underlying myocardial ischaemia during long term treatment.

Adrenergic beta-Antagonists↗
PubMed1976

Assessment of metoprolol, a cardioselective beta-blocking agent, during chronic therapy in patients with angina pectoris.

Ten patients with typical angina pectoris and without hypertension, congestive heart failure or other disease were treated with alternating four-week courses of metoprolol (alpha beta1 cardioselective beta-blocking agent), propranolol and placebo. Midway through each four-week period, drug dosage was doubled; thus, regimes were metoprolol, 150 and 300 mg/day, propranolol, 120 and 240 mg per day and placebo, 3 and 6 tablets per day. Serum concentrations of metoprolol increased with increasing dosage in a proportion very similar to that seen with propranolol. Statistically significant reductions in angina frequency/nitroglycerin consumption, and statistically significant increases in total work performed on a bicycle ergometer, were found with both active compounds when compared with placebo. No significant differences were noted between the two active compounds. Though most patients showed greatest improvement on the higher of the two drug dosages, three patients with metoprolol and two with propranolol responded best on the lower dose regime. Both compounds reduced heart rate at rest and during exercise. Neither reduced arterial pressure at rest, but both reduced arterial pressure during exercise. It is concluded that metoprolol is as effective as propranolol in the reduction of angina attacks and improvement in exercise tolerance during chronic therapy in patients with uncomplicated angina pectoris. It is now appropriate to study the effects of metoprolol in patients with coronary artery disease in whom the harmful effects of non-selective beta-blockade heretofore have precluded optimal therapy with beta-blocking drugs.

Adult↗