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Effects of Flunarizine and Pentoxifylline on Walking Distance and Blood Rheology in Claudication

Second Department of Surgery and Department of Clinical Chemistry, Helsinki University Central Hospital and Reseach Center, Orion Pharmaceutical Co., Helsinki, Finland

Kari Salmenkivi

Second Department of Surgery and Department of Clinical Chemistry, Helsinki University Central Hospital and Reseach Center, Orion Pharmaceutical Co., Helsinki, Finland

Stig Sundberg

Second Department of Surgery and Department of Clinical Chemistry, Helsinki University Central Hospital and Reseach Center, Orion Pharmaceutical Co., Helsinki, Finland

Riitta Johnsson

Second Department of Surgery and Department of Clinical Chemistry, Helsinki University Central Hospital and Reseach Center, Orion Pharmaceutical Co., Helsinki, Finland

Ariel Gordin

Second Department of Surgery and Department of Clinical Chemistry, Helsinki University Central Hospital and Reseach Center, Orion Pharmaceutical Co., Helsinki, Finland

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 dis tance 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<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 (P_max), which was initially elevated, decreased significantly (p<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.

Angiology, Vol. 35, No. 6, 366-372 (1984)
DOI: 10.1177/000331978403500605


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