The Pharmaceutical Journal
Vol 273 No 7325 p706
13 November 2004

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Effectiveness of atenolol for patients with hypertension questioned

Concerns about the effectiveness of atenolol in preventing deaths from strokes and heart disease in patients with hypertension have been raised in a recent study.
Researchers from two university hospitals in Sweden conducted a systematic review to evaluate the effectiveness of atenolol compared with placebo or alternative antihypertensive treatments.

The review included four studies comprising 6,825 patients comparing atenolol with placebo or untreated controls, and five studies comprising 17,671 patients comparing atenolol with other antihypertensive drugs. Patients were followed up for an average of 4.6 years after treatment for high blood pressure.

The researchers’ statistical analysis shows that atenolol is effective at lowering blood pressure in hypertensive patients and reduces the incidence of stroke compared with placebo, but this does not result in a reduction in deaths from heart disease or stroke. In addition, atenolol is not any more effective at lowering blood pressure than alternative antihypertensive drugs and there is a slight increase in the overall risk of death related to cardiovascular disease, strokes and heart attacks. They conclude that they “have doubts about the suitability of atenolol as a first-line antihypertensive drug and as a reference drug in outcome trials of hypertension” (Lancet 2004; 364:1684).