Atenolol uses and side effects
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Atenolol: Uses and Side Effects
Uses of Atenolol
Hypertension Management
Atenolol is widely used as an effective antihypertensive agent. It significantly reduces both systolic and diastolic blood pressure in patients with essential hypertension1 2. Comparative studies have shown that atenolol lowers blood pressure to a similar extent as other beta-adrenoceptor antagonists, ACE inhibitors, and calcium antagonists8. It is particularly effective in elderly patients and women with pregnancy-associated hypertension8.
Cardiovascular Protection
Atenolol is beneficial in reducing cardiovascular mortality and preventing infarct recurrence in patients with myocardial infarction8. It also improves objective and subjective indices in patients with stable angina pectoris8. Additionally, atenolol has been shown to reduce platelet adhesion, which may contribute to its cardio-protective effects1.
Treatment of Infantile Hemangiomas
Atenolol has been used as an alternative to propranolol for treating infantile hemangiomas (IH). Studies indicate that atenolol is effective in inducing clinical involution of IH with fewer severe side effects compared to propranolol4 5.
Management of Supraventricular Arrhythmias
Atenolol is used to prevent the recurrence of supraventricular arrhythmias once control is achieved by intravenous administration8.
Intraocular Pressure Reduction
Topical application of atenolol has been found to lower intraocular pressure in patients with ocular hypertension, making it potentially useful in clinical settings10.
Side Effects of Atenolol
Common Side Effects
Atenolol is generally well tolerated, with few common side effects reported. These include mild side effects such as drowsiness and fatigue, although these are less frequent compared to other beta-blockers like propranolol2 6 7.
Central Nervous System (CNS) Effects
Atenolol has a lower incidence of CNS-related side effects such as vivid dreams, hallucinations, and sleep disturbances compared to more lipophilic beta-blockers like metoprolol7. This is attributed to its low lipid solubility and limited brain penetration7 8.
Metabolic Effects
Atenolol can affect lipid metabolism, leading to increased plasma levels of total triglycerides and very low-density lipoprotein (VLDL) triglycerides1 8. In patients with type 2 diabetes mellitus, atenolol has been shown to alter fatty acid metabolism and associated metabolic hormones, particularly under conditions of metabolic stress such as exercise9.
Rare and Severe Side Effects
In rare cases, atenolol can induce drug-induced lupus erythematosus, characterized by skin rashes and the presence of antihistone antibodies3. Discontinuation of the drug typically leads to the resolution of symptoms3.
Comparison with Other Beta-Blockers
Compared to propranolol, atenolol is associated with fewer severe side effects, particularly in the treatment of infantile hemangiomas4 5. Propranolol has a higher incidence of adverse events such as agitation and bronchial hyperreactivity5.
Conclusion
Atenolol is a versatile beta-1 adrenergic antagonist used primarily for managing hypertension, providing cardiovascular protection, and treating conditions like infantile hemangiomas and supraventricular arrhythmias. It is generally well tolerated with a favorable side effect profile compared to other beta-blockers. However, it can have metabolic effects and, in rare cases, induce severe conditions like lupus erythematosus. Overall, atenolol remains a well-established treatment option in cardiovascular medicine.
Sources and full results
Most relevant research papers on this topic
Increased platelet adhesion and aggregation in hypertensive patients: effect of atenolol.
Atenolol effectively reduces blood pressure and platelet adhesion in hypertensive patients, potentially contributing to cardio-protective effects.
RCTControlled study of atenolol in treatment of hypertension.
Atenolol effectively reduces blood pressure in patients with essential hypertension, with an optimum daily dose of 200 mg, and shows no significant difference in side effects between placebo and active treatment.
RCTAtenolol-induced lupus erythematosus.
Atenolol, a beta-blocker used to treat hypertension, can cause drug-induced connective tissue disease and skin rash, with discontinuing the drug causing the rash to disappear.
Case ReportTreatment of infantile haemangiomas with atenolol: comparison with a historical propranolol group.
Atenolol is effective in treating infantile haemangiomas with similar effects and fewer severe side effects compared to propranolol.
Observational StudyShould Propranolol Remain the Gold Standard for Treatment of Infantile Hemangioma? A Systematic Review and Meta-Analysis of Propranolol Versus Atenolol
Propranolol treatment leads to a higher rate of complete response than atenolol for infantile hemangioma, but its use must be weighed against its greater side effect profile.
Meta-AnalysisThe effects of atenolol (tenormin) and methyldopa on simple tests of central nervous function.
Atenolol is unlikely to produce side effects of sedation or drowsiness, while methyldopa does.
RCTCNS-related side-effects with metoprolol and atenolol
Metoprolol is associated with a higher incidence of CNS side-effects compared to atenolol, while both drugs effectively control blood pressure.
RCTAtenolol
Atenolol effectively lowers blood pressure, improves angina symptoms, and reduces cardiovascular mortality in patients with mild to moderate hypertension, stable angina pectoris, and certain cardiac arrhythmias.
Highly CitedThe beta-1 adrenergic antagonist, atenolol, decreases acylation stimulating protein, exercise capacity and plasma free fatty acids in men with type 2 diabetes.
Atenolol alters fatty acid metabolism and associated hormones during exercise in men with type 2 diabetes, especially during metabolic stress conditions like postprandial state, acute exercise, and obesity.
Non-RCTEffect of topical atenolol on intraocular pressure.
Topical atenolol effectively lowers intraocular pressure in patients with ocular hypertension, potentially being clinically useful without causing side effects.
RCT