Acyl guanidines are provided which are sodium/proton exchange (NHE) inhibitors which have the structure ##STR1##wherein n is 0 to 4; X is a bond, O, S, SO, SO.sub.2, CO, ##STR2##or NR.sup.7 ; Y is a bond, O, S, SO, SO.sub.2, CO, ##STR3##or NR.sup.7 ' wherein at least one of X and Y is other than a bond; and R.sup.1, R.sup.2, R.sup.3, R.sup.4, R.sup.5, R.sup.6, R.sup.7 and R.sup.a, R.sup.b, R.sup.c, R.sup.d are as defined herein, and are useful as antianginal, cardioprotective agents, antiischemic agents, and agents for peripheral vascular disease including intermittent claudication. In addition, a method is provided for preventing or treating angina pectoris, cardiac dysfunction, myocardial necrosis, arrhythmia, peripheral vascular diseases (PVD), including peripheral atherosclerotic disease (PAD), including intermittent claudication, Raynaud's diseases, and LeRiches Syndrome, pain, parethesia or discomfort in the lower limb and gluteal regions produced by vascular (e.g. arterial) insufficiency (where symptoms are initiated or worsened with ambulation), employing the above acyl guanidines.

intermittent claudication/nekroz

Bicyclic acyl guanidine sodium/proton exchange inhibitors and method

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