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April 3, 1972

Alprenolol Treatment of Angina Pectoris

Author Affiliations

Goteborg, Sweden

JAMA. 1972;220(1):128. doi:10.1001/jama.1972.03200010112033

To the Editor.—  Lyon and associates recently wrote (215:1669, 1971) that they found alprenolol, a β-adrenergic blocker, ineffective in angina pectoris at a dosage of 100 mg four times daily. They criticize a trial I took part in,1 suggesting that "... when their data are regarded objectively, the results are similar to ours." We had concluded that in 14 out of 21 patients, alprenolol produced a clinically significant improvement. This was based on daily subjective rating of anginal severity and nitroglycerin consumption. The statistical evaluation of these variables provided confidence limits of P <.05 or better.Lyon et al, in order to classify the patient as improved, demanded a 50% reduction of nitroglycerin consumption and a 50% increase of number of trips in a two-step exercise test. We do not consider that nitroglycerin consumption or attack rate can be assigned a quantitative value. Decrease in attack rate may lead