Gout drug used to treat angina

A drug which has been used to treat gout for more than 40 years has also been shown to be effective against angina.

The drug - allopurinol - has few side effects and appears to work by reducing the energy needed by the heart to beat, allowing people with angina to exercise more.

It also has the added benefit of being cheaper than anti-anginal drugs such as ranolazine and ivabradine currently in use.

Around two million people in the UK suffer from angina or severe chest pain, usually caused by narrowing of the arteries. People with angina may also have shortness of breath, especially when doing any type of physical activity.

Angina can also substantially reduces quality of life, with one in three patients having an angina "attack" at least once a week.

The study, published to-day in the Lancet journal, involved 65 patients with chronic angina from the Tayside region. All were given a positive exercise tolerance test at the start of the study which measures the time taken for the heart to run out of oxygen whilst exercising.

Half the patients were given 600mg of the drug and the other half a placebo. After six weeks the groups were switched over so that all 65 patients were tested with the drug.

The findings showed that patients receiving allipurinol were able to exercise for 25 per cent longer before experiencing chest pain compared with those given the placebo.

Experimental studies on allopurinol suggests that it inhibits the enzyme xanthine oxidase, which in turn reduces the energy used by the heart in each beat or "stroke".

If this also occurs in man, this type of drug could become a new treatment for patients with angina as it would allow more oxygen and energy to reach heart tissue suffering from an inadequate blood supply.

The authors of the study said: “Allopurinol is inexpensive compared with some other antianginal drugs such as ranolazine and ivabradine, and has a favourable long-term (>40 years) safety record for the treatment of gout.

"Compared with older antianginal drugs (nitrates, ß blockers), allopurinol is better tolerated because it does not reduce blood pressure or heart rate, and does not cause many side-effects, such as headaches and tiredness, that occur frequently with nitrates and ß blockers.”

This article was published on Tue 8 June 2010