CHOICE OF A CORONARY VASODILATOR DRUG IN CLINICAL PRACTICE

Abstract

Each year new drugs are introduced that are alleged to have coronary vasodilator action. After an initial enthusiastic endorsement, most of these agents fall into disrepute or lose popularity because of the uncertainty arising from conflicting claims. Frequently, the clinical value of a coronary vasodilator drug has been estimated from its pharmacological action in animals or from its performance in uncontrolled studies in human disease; less often it has been appraised from carefully controlled analyses of the subjective sensation of pain in patients with angina pectoris. Some attempts to determine the effect of drugs on the severity and frequency of anginal attacks occurring spontaneously or induced by exercise have successfully removed or minimized the element of bias; but even the best of these methods employing the double blind technique with placebo and test materials have left much to be desired. Such procedures would be acceptable for assaying the vasodilator potency