From the Guidelines
Atenolol should not be the first choice for treating hypertension due to its inferiority in preventing stroke and potential to induce weight gain, adverse effects on lipid metabolism, and increase the incidence of new-onset diabetes, as reported in the 2012 European guidelines on cardiovascular disease prevention in clinical practice 1. When considering the use of atenolol, it is essential to weigh the benefits and risks, particularly in patients with multiple metabolic risk factors. The medication works by blocking the effects of adrenaline on beta receptors in the heart, which slows heart rate, reduces the force of heart contractions, and lowers blood pressure. Some key points to consider when using atenolol include:
- Typical starting dose: 25-50 mg once daily, which can be increased to a maximum of 100 mg daily if needed
- Importance of taking the medication at the same time each day and not stopping it suddenly to avoid rebound effects
- Common side effects: fatigue, dizziness, cold hands and feet, and slow heartbeat
- Need for caution in patients with asthma, COPD, diabetes, or certain heart conditions
- Regular monitoring of heart rate and blood pressure is necessary while on this medication According to the 2012 European guidelines, beta-blockers like atenolol can adequately lower blood pressure and reduce the risk of cardiovascular morbidity and mortality, but their position as first-choice antihypertensive drugs has been questioned due to their potential drawbacks 1. In contrast, the 2013 ACCF/AHA focused update incorporated into the ACCF/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction recommends initiating beta blockers orally within the first 24 hours in the absence of contraindications, but with greater caution in the early use of intravenous beta blockers 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Atenolol Overview
- Atenolol is a beta-blocker used to treat hypertension and heart failure 2, 3, 4, 5, 6
- It is a cardioselective beta-blocker, meaning it primarily affects the heart rate and contractility 2, 6
Efficacy and Safety
- Atenolol has been shown to reduce blood pressure and heart rate in patients with hypertension 3, 6
- However, its efficacy in reducing cardiovascular morbidity and mortality has been questioned 3, 4
- Atenolol has been associated with adverse reactions such as metabolic disturbance, bronchospasm, and sexual dysfunction 2
Comparison with Other Beta-Blockers
- Atenolol has been compared to other beta-blockers such as bisoprolol, metoprolol, and carvedilol in terms of efficacy and safety 2, 4, 5
- Carvedilol has been shown to be more effective than atenolol in reducing all-cause mortality in patients with heart failure 4
- Atenolol has been found to have similar efficacy to metoprolol tartrate and carvedilol in reducing the risk of rehospitalization for heart failure 5