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Biomedical subjects

R Alfiero

Publications and source records attributed to R Alfiero.

11 recordsLinked to original sources
PubMed1997

Comparison of efficacy of spirapril and enalapril in control of mild-to-moderate hypertension.

The efficacy of spirapril, 6 mg once daily, was compared with enalapril, 5-20 mg once daily, in the control of mild-to-moderate hypertension in a placebo-controlled, parallel-group study. A total of 251 patients participated in the study, all of whom underwent a 4-week washout period on placebo. Thereafter, 100 patients were randomized to spirapril, 6 mg once daily, 101 patients to enalapril, 5-20 mg once daily, and 50 patients remained on placebo. Sitting diastolic blood pressure (DBP) and systolic blood pressure (SBP) were measured at 2-weekly clinic visits. Blood pressure profiles during peak and trough plasma drug concentrations (2-4 hours and 24-26 hours postdose, respectively) were determined at baseline and 4 and 8 weeks after starting the double-blind phase. Compared with placebo, treatment with both spirapril and enalapril resulted in significant reductions (p < 0.001) in DBP and SBP. DBP was reduced to a greater extent with spirapril than with enalapril both at peak (-17.4 mmHg vs. -14.8 mmHg) and trough (-14.7 mmHg vs. -12.4 mmHg). Thus, although the trough/peak DBP ratios for spirapril and enalapril were very similar (84% vs. 82%), actual reductions in DBP were different. Spirapril and enalapril treatment resulted in similar reductions in SBP at both peak and trough levels. Both drugs were well tolerated, and there were very few adverse events or changes in hematological or biochemical parameters during the study. In conclusion, spirapril, 6 mg once daily, as the initial and maintenance dose, is at least as effective and well tolerated as enalapril individually titrated.

Administration, Oral↗
PubMed1992

An evaluation of the safety of the beta-modulator cicloprolol in chronic heart failure.

The new beta-adrenoceptor partial agonist cicloprolol acts as a beta-agonist at normal levels and as a beta-antagonist at high levels of adrenergic discharge. Treatment with cicloprolol should protect the heart against excessive stimulation, while providing a baseline level of sympathetic drive. The clinical interest of such a profile is, however, not yet established in heart failure. Accordingly this study examined the safety of oral cicloprolol, a step necessary before undertaking efficacy comparison with other compounds recently proposed to treat heart failure. Twenty-five patients were studied. Cicloprolol was given once a day for 2 weeks in a crossover double-blind placebo-controlled design. Follow-ups were obtained at baseline and at the end of each period. At baseline all patients had clear evidence of heart failure. Cicloprolol did not affect resting heart rate and blood pressure, but it reduced significantly peak exercise heart rate and peak rate-pressure product. The effect was especially significant in patients with sinus rhythm. The drug did not induce bradycardia or arrhythmias. Resting and exercise ejection rate were not affected. Cicloprolol improved the quality of life and the work capacity of 5 of 12 patients with congestive failure due to ischemic etiology. Side effects were few and similar with placebo and cicloprolol. Thus, short-term administration of cicloprolol is safe in moderate heart failure.

Administration, Oral↗
PubMed1991

A double-blind dose-response study of amlodipine in patients with stable angina pectoris.

Sixty patients (31 male, 29 female) were studied in a 4-week double-blind parallel dose-response study. Patients received amlodipine 1.25 mg (n = 12), 2.5 mg (n = 12), 5 mg (n = 12), 10 mg (n = 12) or placebo (n = 12) once a day. Anti-anginal efficacy was assessed by sequential treadmill testing 24 h post-dose, frequency of anginal attacks and consumption of nitroglycerin, patient and investigator assessment. In the analysis of the final vs baseline total exercise time, the difference between those on amlodipine and those on placebo was significant (P less than 0.01), (all doses). Mean total exercise time increased by 24% in the amlodipine 10 mg group compared with a 20% decrease in the placebo group. The time to onset of angina increased by 37% in the amlodipine 10 mg group, compared with a 16.5% decrease in the placebo group. Differences were statistically significant for the 1.25, 5 and 10 mg amlodipine groups vs placebo. ST-segment charges and rate-pressure product were not affected significantly. There was a statistically significant difference in angina attack frequency and nitroglycerin tablet consumption (P less than 0.05) for all dose groups vs placebo. The majority of patients receiving amlodipine reported improvement in angina symptoms. Side-effects were frequent but mild and dose-related. Amlodipine has significant anti-anginal efficacy. The mechanisms underlying the anti-ischaemic effects of amlodipine are still under discussion.

Administration, Oral↗
PubMed1987

Effects of captopril on the physical work capacity of normotensive patients with stable-effort angina pectoris.

Twelve normotensive patients with coronary artery disease and stable effort-induced angina pectoris were selected: the antiischemic effect of captopril was studied. A maximal cycloergometer effort test was obtained before (base) and after administration of placebo or captopril (50 mg p.o.). The following parameters were measured: heart rate (HR), blood pressure (BP), maximal rate/pressure product (MRPP), maximal workload sustained, (MWS), maximal working time (MWT), and S-T depression at MRPP. The base and placebo were similar. Compared to them captopril augmented the MWT, increased the MWS, reduced S-T depression at MRPP, and decreased the number of patients with effort-induced angina pectoris. The antiischemic effect of captopril seems related both to its effect on HR and BP, and to a local enhancement of coronary blood flow.

Angina Pectoris↗
PubMed1985

Ergometric evaluation of the effects of captopril in hypertensive patients with stable angina.

The antihypertensive and anti-ischaemic effects of methyldopa and captopril were compared in 12 hypertensive patients with coronary artery disease. The antihypertensive effect of alpha-methyldopa (A) and captopril (C) were significant and similar. On the other hand, while methyldopa did not increase the product of systolic pressure and heart rate and did decrease the effort-induced S-T segment depression, C increased the double product (DP) and decreased the ischaemic S-T changes. Captopril might be useful in the treatment of hypertensive patients with coronary artery disease.

Aged↗