Objective Evaluation of Coronary Vasodilator Drugs

Clinical Evaluation of Verapamil in Angina Pectoris

“…The suggestibility of anginal patients with any new preparation has been well established (Greiner et al, 1950) and the favourable response to placebos clearly shown (Cole et al, 1968), so that the necessity for a double-blind trial becomes apparent. Neumann and Luisada (1966) did find significant improvement in the incidence of angina with verapamil in a double-blind trial in 30 geriatric patients, but assessment was again wholly subjective and therefore of limited value in view of the lack of direct relationship between the development and severity of angina and the degree of actual coronary insufficiency (Russek et al, 1955).…”

Stress Tests and the Evaluation of Anti‐anginal Drugs*

“…To begin, it should be recognized that Russek and associates used a selected group of angina-prone subjects who were then instructed to complete a Master 2-Step Test before and after the administration of the nitrate being tested (6)(7)(8)(9)(10)(11). Following this procedure, the electrocardiographic findings were studied, and conclusions with respect to the action of the drug were derived from an examination of the electrocardiographic responses.…”

Clinical Evaluation of Anti-Anginal Drugs with Particular Reference to Benziodarone, a New Coronary Vasodilator

“…A drug which improves angina without producing a corresponding improvement in myocardial blood supply may result in increased myocardial ischaemia by allowing excessive exertion (Sandler,I96I). Finally the lack of any direct relationship between the development and severity of anginal pain and the degree of coronary insufficiency (Russek, Zohman and Dorset, 1955) trocardiographic control, which relies as little as possible on the patient's interpretation of his response to treatment. Gillott (1959) reported considerable improvement with benziodarone in 77% of i8o anginal patiehts but since assessment was mainly subjective and entirely uncontrolled the value of these observations is dubious.…”

“…Gillott's study was based on an uncontrolled and subjective evaluation of the action of benziodarone. Assessment of any anti-anginal drug, however, must take into consideration the suggestibility of anginal patients, the limitations of subjective data provided by the patients themselves, and the lack of any direct relationship between the development and severity of anginal pain and the degree of coronary insufficiency (Russek, Zohman and Dorset, 1955).It is with these considerations in mind that it was decided to carry out a controlled doubleblind and objective evaluation of the use of benziodarone in the treatment of angina pectoris. …”