cinnarizine and Intermittent-Claudication

Topics: Arterial Occlusive Diseases; Cardiovascular Agents; Cinnarizine; Clinical Trials as Topic; Dihydroergotamine; Dihydroergotoxine; Drug Combinations; Exercise Test; Flunarizine; Humans; Intermittent Claudication; Nafronyl; Pentoxifylline; Placebos; Pyrrolidines; Secologanin Tryptamine Alkaloids; Yohimbine

Flunarizine, a long-acting calcium antagonist, was studied in patients with peripheral vascular disease in order to assess its effects on blood viscosity, erythrocyte deformability, platelet activity and some clinical parameters. A randomized double-blind study was performed; all patients were given a standard diet, invited to abstain from smoking and to carry out a regular daily exercise (walking). After a 2-month run-in period the patients were divided into two groups: one was treated with flunarizine 10 mg/day and the other with placebo. The group treated with flunarizine presented marked and significant reduction of erythrocyte filtration time and blood viscosity and an improvement of the treadmill-free interval with a correlation between the parameters considered.

Topics: Aged; Blood Viscosity; Calcium Channel Blockers; Cinnarizine; Double-Blind Method; Erythrocyte Deformability; Flunarizine; Humans; Intermittent Claudication; Middle Aged; Piperazines; Platelet Aggregation; Rheology

Thirty-one patients, mean age 60 years (range 45-80 years), with a typical history and objective symptoms of intermittent claudication with a reported maximal walking distance less than 500 m, were included in a cross-over study. After a one month's run-in period on placebo, the patients were randomized into two groups: one group started with flunarizine (5 mg t.i.d.) and the other with pentoxifylline (400 mg t.i.d.). The treatment lasted 3 months, whereafter the medications were changed. The trial followed a double-blind design. The median of the maximal walking distance was 255 m after the placebo period, increasing significantly (p less than 0.01) during both medication periods: by 43% and 18% during flunarizine and pentoxifylline, respectively. No changes were recorded in the ankle systolic blood pressure ratio ( ASBP -ratio) after placebo or either medication period. Red cell rigidity (Pmax), which was initially elevated, decreased significantly (p less than 0.05) during both medication periods, but there were no significant differences between the two drugs. No changes were found in whole blood or plasma viscosity. We conclude that the decrease in red cell rigidity may have contributed to the increased walking distance.

Topics: Aged; Arteriosclerosis; Blood Pressure; Blood Viscosity; Cinnarizine; Clinical Trials as Topic; Double-Blind Method; Erythrocytes; Exercise Test; Flunarizine; Humans; Intermittent Claudication; Leg; Middle Aged; Osmotic Fragility; Pentoxifylline; Physical Exertion; Piperazines; Regional Blood Flow; Rheology; Smoking; Theobromine; Vasodilator Agents

The clinical significance of drugs improving red cell deformability is not confirmed. We established the effect of physical training alone and combined with flunarizine on intermittent claudication. Twelve patients aged 48-73 years were included in the study. Pain-free walking distance on treadmill, ankle/arm pressure ratio and transcutaneous oxygen tension were measured. Walking distance increased significantly (p less than 0.05) by 130% from 75 m to 173 m during the first year when the patients were on programmed physical training. Ankle/arm pressure ratio also increased significantly (p less than 0.05) from 0.46 to 0.55 during this period. The increase in walking distance ceased when the programmed physical training was discontinued for 6 months. During the following double-blind, cross-over medication period the patients were given flunarizine 5 mg b.i.d. and placebos in randomized order for 3 months each. They also continued the same programmed physical training as during the first year. Walking distance increased, albeit not significantly, with time to 392 m after the second medication period. There was no difference, however, between flunarizine and placebo. Ankle/arm pressure ratio was of the same magnitude as at the beginning of the trial. Oxygen tension measurements did not give consistent results. We conclude that programmed physical training increased walking distance as a function of time. Flunarizine had no effect on the performance of patients with intermittent claudication.

Topics: Aged; Calcium Channel Blockers; Cinnarizine; Clinical Trials as Topic; Double-Blind Method; Female; Flunarizine; Humans; Intermittent Claudication; Locomotion; Male; Middle Aged; Physical Education and Training; Piperazines

Topics: Aged; Cinnarizine; Doppler Effect; Double-Blind Method; Female; Flunarizine; Humans; Intermittent Claudication; Leg; Male; Middle Aged; Physical Exertion; Piperazines; Ultrasonography

In a group of 45 patients with mild to moderately severe claudication studied over the same 4-month period, cinnarizine administration (75 mg 3-times daily) was associated with a greater than 20% improvement in walking distance in 65% of the patients, who derived significantly more benefit than the 30% of placebo responders. The mean improvement in walking distance was 11% for the placebo group compared to 142% for cinnarizine-treated patients. An open 12-month follow-up showed that improvements in walking distance with cinnarizine were maintained in all 12 patients, whereas in the 10 control patients only 10% reported improvement. Objectively, significant plethysmographic improvements were detected only for the cinnarizine-treated patients and shown by an increase in arterial flow-pressure dynamics of the lower limbs.

Topics: Aged; Blood Pressure; Cinnarizine; Double-Blind Method; Drug Evaluation; Female; Humans; Intermittent Claudication; Male; Middle Aged; Patient Compliance; Physical Exertion; Piperazines

Topics: Arteriosclerosis; Calcium; Cerebrovascular Disorders; Cinnarizine; Clinical Trials as Topic; Double-Blind Method; Humans; Intermittent Claudication; Leg Ulcer; Paresthesia; Piperazines; Vascular Diseases; Vasodilator Agents; Venous Insufficiency

A multicentre, double-blind, crossover study monitoring walking distance and symptomatology was set up to compare the efficacy of cinnarizine with that of placebo in the treatment of patients with intermittent claudication. Walking distances were statistically significantly increased by cinnarizine treatment when it was given before placebo. This improvement was maintained without further significant deterioration when the patients were switched to placebo therapy. A smaller but statistically significant increase in walking distance was observed after the first 12 weeks of tarizine treatment an additional increase in mean walking distance, comparable to that seen during the first half of the study, was observed in these subjects. This improvement failed to reach a level of statistical significance because of the variation in response between individual patients.

Topics: Adult; Aged; Cinnarizine; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Intermittent Claudication; Male; Middle Aged; Piperazines; Placebos

Topics: Arterial Occlusive Diseases; Cinnarizine; Cyclandelate; Dilatation; Humans; Intermittent Claudication

Topics: Arterial Occlusive Diseases; Arteriosclerosis; Biological Transport; Blood Viscosity; Calcium; Cell Membrane Permeability; Cinnarizine; Humans; Intermittent Claudication; Muscle, Smooth; Papaverine; Vascular Diseases

Topics: Blood Viscosity; Cerebral Infarction; Cinnarizine; Erythrocyte Membrane; Fibrinogen; Humans; Intermittent Claudication; Myocardial Infarction; Physical Exertion; Vascular Diseases

It has been suggested that, by reducing the viscosity of blood, flow through capillaries is increased with consequent improvement in the symptoms of patients with peripheral vascular disease. We examined the effects of treatment with drugs purported to reduce blood viscosity to test the validity of this claim. Measurements of viscosity and the rate of blood flow to the leg were made in a group of patients before and after treatment with three different drugs--tetranicotinoylfructose (Bradilan), oxypentifylline (Trental) and cinnarizine (Stugeron). All patients had intermittent claudication in one leg and the distribution of arteriosclerosis was similar in each patient. After treatment there was little or no change in blood viscosity and no change in the rate of flow recorded in the symptomatic legs. We did not find any objective evidence to support the use of these drugs in patients with intermittent claudication.

Topics: Aged; Blood Viscosity; Cinnarizine; Female; Humans; Intermittent Claudication; Leg; Male; Middle Aged; Niacin; Pentoxifylline; Plethysmography; Regional Blood Flow; Time Factors; Xenon Radioisotopes