Tenormin (Atenolol) - Summary

TENORMIN SUMMARY

TENORMIN® (atenolol), a synthetic, beta₁-selective (cardioselective) adrenoreceptor blocking agent.

Hypertension: TENORMIN is indicated in the management of hypertension. It may be used alone or concomitantly with other antihypertensive agents, particularly with a thiazide-type diuretic.

Angina Pectoris Due to Coronary Atherosclerosis: TENORMIN is indicated for the long-term management of patients with angina pectoris.

Acute Myocardial Infarction: TENORMIN is 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 (eg, elderly patients with systolic blood pressure below 120 mm Hg) seemed less likely to benefit.

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TENORMIN NEWS HIGHLIGHTS

Published Studies Related to Tenormin (Atenolol)

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 [generic for Tenormin]-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.

Short-term effects of cilazapril and atenolol on P-wave dispersion in patients with hypertension. [2008.02]
INTRODUCTION: P-wave dispersion (PWD) has been shown to be a non-invasive electrocardiographic predictor for development of atrial fibrillation (AF). Thus, it may be possible to decrease AF risk through improvement in PWD. Our objective was to compare the effects of cilazapril and atenolol [generic for Tenormin] on P-wave duration and dispersion in patients with hypertension... CONCLUSION: Both cilazapril and atenolol treatments resulted in improvement in PWD.

Antihypertensive efficacy of zofenopril compared with atenolol in patients with mild to moderate hypertension. [2007.10]
Two first-line antihypertensive therapies for initiating treatment in hypertension were compared, the angiotensin-converting enzyme inhibitor (ACEI) zofenopril and the beta-blocker atenolol [generic for Tenormin]. The study was multi-centre and double-blind, and included 304 middle-aged to elderly patients with mild to moderate hypertension who were randomized to receive either zofenopril 30-60 mg once daily (od) or atenolol 50-100 mg od for 4 weeks with the possibility to an up-titration in non-responding patients...

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Clinical Trials Related to Tenormin (Atenolol)

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.

A Randomized, Open-Label, LOSARTAN Therapy on the Progression of Aortic Root Dilation in Patients With Marfan Syndrome [Enrolling by invitation]
To assess the efficacy of angiotensin II receptor blocker, Losartan, to prevent progressive dilation of aortic root in patients with Marfan syndrome.

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).

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 Pilot Study Comparing Nebivolol and Atenolol and Its Effects With Exercise in Patients With Mild to Moderate Hypertension [Completed]

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TENORMIN PATIENT REVIEWS / RATINGS / COMMENTS

Tenormin review by 35 year old female patient
		Rating
Overall rating:
Effectiveness:		Highly Effective
Side effects:		Mild Side Effects
		Treatment Info
Condition / reason:		Tachycardia
Dosage & duration:		25 mg taken twice per day for the period of 12 years
Other conditions:		Type I Diabetes, Depression, Panic Disorder
Other drugs taken:		Insulin, Xanax, Klonopin, varying Anti-Depressants
		Reported Results
Benefits:		The benefits were immediate relief from a "racing heart" or tachycardia caused by anxiety. I use this medicine prophylactically and found that it is very effective in controlling my heart rate and keeping it within a normal range. The only time it does not work is if I have a full-blown panic attack. At that point, other types of medications are used in addition to the atenolol.
Side effects:		The side effects were mild but it did slightly lower my ability to determine if I was having an insulin reaction (hypoglycemia). However, once I adjusted to the medication, it was not a problem.
Comments:		Treatment was started immediately after an initial and severe case of tachycardia. An Echocardiogram ruled out any heart defect and I was started on 25 mg once per day. I stayed on this dose for about 6 years and was able to drop down to 12.5 mg per day for nearly a year. However, my symptoms returned to their original severity and I began taking my starting dose again. A few years later, I was prescribed 25 mg twice per day due to an increase from original symptoms. This is the dose I currently take and it is an effective and very affordable medication.

Tenormin review by 56 year old female patient
		Rating
Overall rating:
Effectiveness:		Marginally Effective
Side effects:		Mild Side Effects
		Treatment Info
Condition / reason:		hypertension
Dosage & duration:		50 mg/daily taken x1/day for the period of 3 yrs
Other conditions:		SOB
Other drugs taken:		hydrochlorathyazide
		Reported Results
Benefits:		Slowed heart rate, lowered blood pressure and helped eliminate head-aches that I atributed to increasing BP.
Side effects:		I believe that I have gained weight due to taking BP medication. I feel that my metabolic rate has been affected by these meds.
Comments:		BP meds are taken on a daily basis, and I try to take the meds at the same time each day. I do not take these meds on a with or w/o food timetable.

Tenormin review by 56 year old female patient
		Rating
Overall rating:
Effectiveness:		Marginally Effective
Side effects:		Mild Side Effects
		Treatment Info
Condition / reason:		hypertension
Dosage & duration:		50 mg/daily taken x1/day for the period of 3 yrs
Other conditions:		SOB
Other drugs taken:		hydrochlorathyazide
		Reported Results
Benefits:		Slowed heart rate, lowered blood pressure and helped eliminate head-aches that I atributed to increasing BP.
Side effects:		I believe that I have gained weight due to taking BP medication. I feel that my metabolic rate has been affected by these meds.
Comments:		BP meds are taken on a daily basis, and I try to take the meds at the same time each day. I do not take these meds on a with or w/o food timetable.