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Saturday, 6th November, 2004
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Tenormin was no different to placebo in terms of death from all causes,
cardiovascular causes, or incidence of heart attack.
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 related discussion |
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Results of a study in this week's issue of THE LANCET
suggest that Atenolol (Tenormin?)--one of the most widely prescribed
beta-blockers for reducing blood pressure--may not be effective
in reducing heart attacks or death from cardiovascular causes.
Atenolol
(Tenormin?) is one of the most commonly used beta-blockers
clinically, and has often been used as a reference drug in
randomized controlled trials of high blood pressure.
Beta-blockers work by competitively blocking beta-adrenergic receptors in the heart and juxtaglomerular
apparatus. They lead to decreased heart rate, decreasing the work load
by the heart. They do not produce coronary vasodilatation, but lead to
a shift and redistribution of coronary circulation to the ischemic areas.
It decreases the release of renin from the kidney, thus lowering blood
pressure.
Study details
Concerns that
Atenolol
(Tenormin?)
may not be the best reference drug for comparison
with other antihypertensive drugs led Bo Carlberg (Umea
University Hospital, Sweden) and colleagues to systematically
review the effect of Atenolol
(Tenormin?) on cardiovascular illness and
death among patients with high blood pressure.
The investigators identified four studies that compared
Atenolol
(Tenormin?) with placebo or no treatment, and five studies that
compared Atenolol
(Tenormin?) with other antihypertensive drugs.
The studies included some 24,000 patients followed for more than
4.5 years.
Atenolol
(Tenormin?) was no different to placebo in terms of death from
all causes, cardiovascular causes, or incidence of heart attack;
a trend in reduced stroke incidence was the only favorable
outcome. Atenolol
(Tenormin?) slightly increased all-cause mortality
compared with other antihypertensive drugs, in addition to
showing a trend to increased cardiovascular death and increased
stroke incidence.
In an interview with The Doctors Lounge, Carlberg
said "We have not been able to show that Atenolol
prevents cardiovascular disease in the same magnitude as many
other antihypertensive drugs."
When we asked Dr. Carlberg whether his findings
suggested that Atenolol use is dangerous, he replied: "No. Our
study showed that Atenolol
did not increase the risk of death compared with placebo." Co-author Lars H Lindholm comments: "We have some doubts
about the suitability of Atenolol
(Tenormin?) as a first-line
antihypertensive drug and as a reference drug in outcome trials
of hypertension." It should be noted that this is a
retrospective analysis which needs to be confirmed by
prospective randomized trial.
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References
SOURCES: Carlberg, B. The Lancet, Nov. 6, 2004; vol 364: pp
1684-1689. Bo Carlberg, MD, PhD, department of public health and
clinical medicine, Ume?University Hospital, Sweden.
| Article reviewed by: |
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| Edited
by: |
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Carolyn Merritt (Licensed Practical Nurse).
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Reviewed
by: |
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Theresa Jones (Registered Nurse).
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