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Review: atenolol may be ineffective for reducing cardiovascular morbidity or all cause mortality in hypertension

Clinical impact ratings GP/FP/Primary care IM/Ambulatory care Cardiology

Key Words: antihypertensive agents • atenolol • hypertension

The first 150 words of the full text of this article appear below.

METHODS
Data sources: Cochrane Library, Medline, relevant textbooks, and researchers in hypertension.

Study selection and assessment: randomised controlled trials (RCTs) that assessed the effect of atenolol (as the sole first line drug in 1 of the treatment groups) on cardiovascular morbidity or mortality in patients with essential hypertension.

Outcomes: myocardial infarction (MI), stroke, cardiovascular mortality, and all cause mortality.

MAIN RESULTS
8 RCTs met the selection criteria. 2 major comparisons were made. Atenonol compared with placebo or with untreated controls (4 RCTs, n = 6825). Mean reduction in blood pressure (BP) attributed to atenolol ranged from 4.0–18.0 mm Hg systolic and 2.9–11.0 mm Hg diastolic. The groups did not differ for MI, stroke, cardiovascular mortality, or all cause mortality (table). Atenolol compared with other antihypertensive drugs (5 RCTs, n = 17 671). Mean BP change with atenolol compared with alternatives ranged from –1.0 to 1.1 mm Hg systolic and . . . [Full text of this article]

J Kennedy Cruickshank, MD

Manchester Royal Infirmary, Manchester, UK