BOX WARNING CESSATION OF THERAPY WITH ATENOLOL
Patients with coronary artery disease, who are being treated with atenolol, should be advised against abrupt discontinuation of therapy. Severe exacerbation of angina and the occurrence of myocardial infarction and ventricular arrhythmias have been reported in angina patients following the abrupt discontinuation of therapy with beta blockers. The last two complications may occur with or without preceding exacerbation of the angina pectoris. As with other beta blockers, when discontinuation of atenolol is planned, the patients should be carefully observed and advised to limit physical activity to a minimum. If the angina worsens or acute coronary insufficiency develops, it is recommended that atenolol be promptly reinstituted, at least temporarily. Because coronary artery disease is common and may be unrecognized, it may be prudent not to discontinue atenolol therapy abruptly even in patients treated only for hypertension. (See DOSAGE AND ADMINISTRATION).
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ATENOLOL SUMMARY
Atenolol Tablets, USP
Atenolol, a synthetic, beta1-selective (cardioselective) adrenoreceptor blocking agent, may be chemically described as Benzene-acetamide, 4-[2-hydroxy-3-[(1-methylethyl)amino]propoxy]-.
Hypertension
Atenolol tablets are indicated in the management of hypertension. They may be used alone or concomitantly with other antihypertensive agents, particularly with a thiazide-type diuretic.
Angina Pectoris Due to Coronary Atherosclerosis
Atenolol tablets are indicated for the long-term management of patients with angina pectoris.
Acute Myocardial Infarction
Atenolol tablets are indicated in the management of hemodynamically stable patients with definite or suspected acute myocardial infarction to reduce cardiovascular mortality. Treatment can be initiated as soon as the patient’s clinical condition allows. (See DOSAGE AND ADMINISTRATION, CONTRAINDICATIONS, and WARNINGS.) In general, there is no basis for treating patients like those who were excluded from the ISIS-1 trial (blood pressure less than 100 mm Hg systolic, heart rate less than 50 bpm) or have other reasons to avoid beta blockade. As noted above, some subgroups (e.g., elderly patients with systolic blood pressure below 120 mm Hg) seemed less likely to benefit.
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NEWS HIGHLIGHTS
Published Studies Related to Atenolol
Effects of losartan on fibrinolytic parameters and von Willebrand factor in Chinese subjects with hypertension: a comparative study versus atenolol. [2009.05]
To compare the effects of losartan and atenolol on plasma fibrinolytic parameters and von Willebrand factor (vWF), Chinese subjects with mild-to-moderate hypertension were randomized to receive losartan (50 mg/day; n = 30) or atenolol (50 mg/day; n = 30) for 8 weeks...
Efficacy of exercise, losartan, enalapril, atenolol and rilmenidine in subjects with blood pressure hyperreactivity at treadmill stress test and left ventricular hypertrophy. [2009.04]
High levels of activity of the renin-angiotensin system (RAS) and sympathetic nervous system (SNS) are related to left ventricular hypertrophy (LVH). A percentage of subjects with hyperactivity to treadmill stress test show LVH to echocardiogram... In conclusion, drugs that block RAS were more efficient in reducing LVH than physical exercise and drugs that block SNS, and such reduction took place regardless of SBP level reduction at rest and peak effort.
Verapamil-sustained release-based treatment strategy is equivalent to atenolol-based treatment strategy at reducing cardiovascular events in patients with prior myocardial infarction: an INternational VErapamil SR-Trandolapril (INVEST) substudy. [2008.08]
BACKGROUND: In patients with prior myocardial infarction (MI), beta-blockers reduce mortality by 23% to 40%. However, despite this favorable effect, adverse effects limit compliance to this medication. The purpose of the study was to compare a beta-blocker-based strategy with a heart rate-lowering calcium antagonists-based strategy in patients with prior MI... CONCLUSIONS: In hypertensive patients with prior MI, a verapamil-SR-based strategy was equivalent to a beta-blocker-based strategy for blood pressure control and prevention of cardiovascular events, with greater subjective feeling of well-being and a trend toward lower incidence of angina pectoris and stroke in the verapamil-SR-based group.
The relationship between the plasma concentration of irbesartan and the antihypertensive response is disclosed by an angiotensin II type 1 receptor polymorphism: results from the Swedish Irbesartan Left Ventricular Hypertrophy Investigation vs. Atenolol (SILVHIA) Trial. [2008.07]
BACKGROUND: The aim of this study was to investigate the effect of the plasma concentration of irbesartan, a specific angiotensin II type 1 receptor (AT1R) antagonist, and the blood pressure response in relation to AT1R gene polymorphisms... CONCLUSIONS: There was an association between plasma concentrations of irbesartan and the blood pressure response for hypertensive patients with AT1R 5245 TT. Because of the small sample size, this study needs to be viewed as hypothesis generating. This is the first study, to our knowledge, indicating that the concentration-response relationship of an antihypertensive drug may be genotype dependent.
Economic evaluation of ASCOT-BPLA: antihypertensive treatment with an amlodipine-based regimen is cost effective compared with an atenolol-based regimen. [2008.02]
OBJECTIVE: To compare the cost effectiveness of an amlodipine-based strategy and an atenolol-based strategy in the treatment of hypertension in the UK and Sweden... CONCLUSIONS: Compared with the thresholds applied by NICE and in the Swedish National Board of Health and Welfare's Guidelines for Cardiac Care, an amlodipine-based regimen is cost effective for the treatment of hypertension compared with an atenolol-based regimen in the population studied.
Clinical Trials Related to Atenolol
VALENCE: Valsartan Versus Atenolol on Exercise Capacity in Hypertensive Overweight Postmenopausal Women [Completed]
The purpose of the study is to show that valsartan compared to atenolol has favorable effects
on exercise capacity, quality of life, diastolic function and elevated blood pressure in
hypertensive postmenopausal overweight women with impaired exercise tolerance despite normal
left ventricular ejection fraction (LVEF).
A Pilot Study Comparing Nebivolol and Atenolol and Its Effects With Exercise in Patients With Mild to Moderate Hypertension [Completed]
Perioperative Effect of Atenolol on Cytokine Profiles [Active, not recruiting]
Studies have shown that beta-blockers such as atenolol when given in the perioperative period
reduce morbidity and mortality. One study showed that atenolol given just during the surgery
period, seemed to improve outcomes up to 2 years later. This is hard to explain since
beta-blockers act on the body by blocking the effects of adrenalin and thereby lowering heart
rate and blood pressure.
This study is designed to find out if perioperative atenolol might exert its long term
effects through an anti-inflammatory mechanism rather than by lowering heart rate and blood
pressure. It is known that inflammation increases after surgery as part of the healing
process. However, it is also becoming clear that low-grade chronic inflammation can also lead
to long term adverse effects.
A Comparison of the Effect of Olmesartan Medoxomil, Losartan Potassium, and Atenolol on the Ability of Overweight Patients With High Blood Pressure to Respond to Insulin [Completed]
To examine the effect of three different blood pressure medications on the insulin
sensitivity in overweight patients with high blood pressure.
Effects of Losartan Versus Atenolol on Aortic and Cardiac Muscle Stiffness in Adults With Marfan Syndrome [Recruiting]
Marfan syndrome is an inherited connective tissue disorder with morbidity and mortality from
aortic dilation and dissection. The degree of aortic dilation and response to beta-blockade
(standard of care) vary in adults with Marfan syndrome. However, aortic stiffness is often
present, and can be a predictor of aortic dilation and cardiovascular complications. In
addition, adults with Marfan syndrome develop left ventricular diastolic dysfunction, which
can progress to heart failure. Aortic stiffness and diastolic dysfunction are important and
logical therapeutic targets in adults with Marfan syndrome.
TGF-beta mediates disease pathogenesis in Marfan syndrome and contributes to aortic
stiffness. The angiotensin receptor blocker, losartan, inhibits TGF-beta activity and
reverses aortic wall pathology in a Marfan mouse model. Losartan also decreases aortic
stiffness and improves diastolic function in hypertension, renal disease and hypertrophic
cardiomyopathy.
This trial is a randomized, double-blind trial of 50 adults with Marfan syndrome, treated
with 6 months of atenolol vs. losartan. Arterial tonometry for aortic stiffness and
echocardiography for diastolic function will be performed at the beginning and end of
treatment. A blood draw for serum markers of extracellular matrix turnover and inflammation
will also be performed at 0 and 6 months. We plan to determine whether losartan decreases
aortic stiffness and left ventricular diastolic dysfunction significantly more than
atenolol.
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PATIENT REVIEWS / RATINGS / COMMENTSBased on a total of 5 ratings/reviews, Atenolol has an overall score of 7.20. The effectiveness score is 7.20 and the side effect score is 8.40. The scores are on ten point scale: 10 - best, 1 - worst. Below are selected reviews: the highest, the median and the lowest rated.
| | Atenolol review by 60 year old female patient | | | Rating |
| Overall rating: | |  |
| Effectiveness: | | Highly Effective |
| Side effects: | | No Side Effects | | |
Treatment Info |
| Condition / reason: | | Extra Heartbeat |
| Dosage & duration: | | 25 mg/day taken 1 /day for the period of 13+ years |
| Other conditions: | | None |
| Other drugs taken: | | None | | |
Reported Results |
| Benefits: | | The benefits are amazing. I felt dizzy and like I was going to faint before I took the drug. These symptoms went away and have stayed away for going on 20 years. I also have seen that it helps with blood pressure and pulse rate. |
| Side effects: | | I have never experienced any adverse side affects. |
| Comments: | | I simply take one tiny tablet each morning. |
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| | Atenolol review by 39 year old female patient | | | Rating |
| Overall rating: | |  |
| Effectiveness: | | Moderately Effective |
| Side effects: | | No Side Effects | | |
Treatment Info |
| Condition / reason: | | blood pressure |
| Dosage & duration: | | 100mg taken once a day for the period of 1 yr. |
| Other conditions: | | o |
| Other drugs taken: | | o | | |
Reported Results |
| Benefits: | | it did keep my blood pressure lower , and i did feel better.and i felt more at ease driving |
| Side effects: | | I felt a little tired at times,and some dizziness i ended up taking it at night
and that seem to help. |
| Comments: | | if i took it in the mornings with a meal. sometimes ,not all time my blood pressure
did not lower like it should,so i took it at night, with a bigger meal.that seem to help, because during the day i seem to have a problem but not as often. |
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| | Atenolol review by 62 year old male patient | | | Rating |
| Overall rating: | | |
| Effectiveness: | | Ineffective |
| Side effects: | | Severe Side Effects | | |
Treatment Info |
| Condition / reason: | | Atrial Fibrillation |
| Dosage & duration: | | 25 mg taken daily for the period of 3 months |
| Other conditions: | | mild hypertension |
| Other drugs taken: | | warafin, lisinopril | | |
Reported Results |
| Benefits: | | none except....slowed heart rate. My afib was NOT diminished, but I assume the drug was helping keep my heart rate when in Afib down somewhat |
| Side effects: | | The 3 months i was on atenolol (25mg) I had vertigo, short term memory loss, anxiety, and hearing issue. All except hearing went away when I switched to a different beta blocker.
Joe Hare |
| Comments: | | once a day 25 mg |
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Page last updated: 2009-10-20
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