Key result
Recent meta-analyses suggest atenolol is inferior to other antihypertensive drugs in preventing vascular morbidity and mortality in patients with primary hypertension.
Why the study?
Does atenolol prevent vascular morbidity and mortality in patients with primary hypertension compared to other antihypertensives?
Does atenolol prevent vascular morbidity and mortality in patients with primary hypertension compared to other antihypertensives?
Understanding the mechanisms behind atenolol's inferiority in preventing vascular events may help design more effective antihypertensive drugs.
Atenolol may warrant avoidance as initial therapy in primary hypertension; leaves open mechanisms of differential vascular protection among antihypertensives.
The beneficial effect of antihypertensive treatment on the risk of major vascular events is well established. Several trials comparing older and newer drugs in the treatment of primary hypertension suggested that it is the blood pressure achieved, rather than choice of the drug that determines most of the primary outcomes. Beta-blockers have been widely used to treat hypertension and are still recommended as first-line drugs in guidelines. However, recent meta-analyses of trials (either placebo-controlled or using drug comparisons) involving atenolol (a popular beta-blocker), have cast doubt on the suitability of atenolol as a first-line antihypertensive drug. We consider the mechanisms which might be responsible for the inferiority of atenolol in preventing vascular morbidity and mortality in patients with primary hypertension. This knowledge may help design drugs that are not only more effective in achieving blood pressure targets but that also markedly decrease vascular events.
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Karagiannis et al. (2006) conducted a review in Primary hypertension. Atenolol vs. Other antihypertensives or placebo was evaluated on Vascular morbidity and mortality. Recent meta-analyses suggest atenolol is inferior to other antihypertensive drugs in preventing vascular morbidity and mortality in patients with primary hypertension.