Antihypertensive and Metabolic Effects of Single and Combined Atenolol Regimens

Abstract

The antihypertensive and metabolic effects of placebo (PL), a fixed combination of hydrochlorothiazide (25 mg) and triamterene (50 mg) (HCTZ/TRI), atenolol (25 mg) (Atc-25), atenolol (50 mg) (Ate-50) and their combination with HCTZ/TRI given once daily, were tested on 256 patients with mild-to-moderate essential-hypertension. After 3 weeks of PL monotherapy, 43 patients were randomized to PL (group 1), 41 patients to HCTZ/TRI (group 2), 44 patients to Ate-25 (group 3), 42 patients to Ate-50 (group 4), 43 patients to Ate-25/HCTZ/TRI (group 5), and 43 patients to Ate-50/HCTZ/TRI (group 6) in a double-blind parallel design study and were followed for 4 weeks. At the end of week 7, those patients who were randomized to groups 5 and 6 were allowed to continue for an additional 12 weeks, if their arterial pressure was satisfactorily controlled. Complete blood counts, blood chemistries, urinalyses, and electrocardiograms were done initially and during the study. Monotherapy with HCTZ/TRI, Ate-25, and Ate-50 had significant and equal antihypertensive effects compared with placebo. (P less than .01). However, the combination of Ate-25/HCTZ/TRI and Ate-50/HCTZ/TRI resulted in further reduction of arterial pressure with the effect being greatest with Ate-50/HCTZ/TRI (P less than .001). Patient groups 3 through 6 had also slower heart rates compared with groups 1 and 2 (P less than .01). Mild, but statistically significant, increases in BUN, glucose, triglycerides, and uric acid were noted in groups 2, 5, and 6 (P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

The Combination of Nebivolol plus Pravastatin is Associated with a More Beneficial Metabolic Profile Compared to that of Atenolol plus Pravastatin in Hypertensive Patients with Dyslipidemia: A Pilot Study

“…No significant changes were observed in serum uric acid levels in this study, in contrast to the uric acid excretion, which was significantly higher in the atenolol group. Although the effect of [-blockers on 1A 0n IIZserum uric acid in our study agrees with previous data (23)(24)(25)(26)(27)(28), in one study with approximately the same number of patients, atenolol inhibited proximal tubular function resulting in a reduced clearance of uric acid (29). Although debatable, claims have been made that serum uric acid levels are a predictor of cardiovascular events, at least in older persons with isolated systolic hypertension (30).…”

Elevated serum uric acid levels in metabolic syndrome: an active component or an innocent bystander?

“…b-Blockers (propranolol [131], atenolol [132], metoprolol [133], timolol [134], and alprenolol [135]) also increased SUA concentrations in some studies. However, this was not confirmed in others [136][137][138]. The mechanisms by which b-blockers influence SUA levels are not known.…”

Betaxolol in the Treatment of Stable Angina Pectoris

“…from our findings and those published pre viously, it appears that with respect to the treatment of angina pectoris, betaxolol 20 mg once daily, is the most effective dose. This is different with respect to the treatment of hy pertension, where smaller doses of betaxolol or atenolol are equally effective [8][9][10]. How ever, the results of this fairly large multicenter study, by no means, do they suggest that betaxolol should only be given in daily doses of 20 mg or greater when treating angina pec toris.…”