Does atenolol differ from other beta-adrenergic blockers?

• Published in: BMC clinical pharmacology 2007-05, Vol.7 (4), p.4-4, Article 4
• Main Authors: Aursnes, Ivar, Osnes, Jan-Bjørn, Tvete, Ingunn Fride, Gåsemyr, Jørund, Natvig, Bent
• Format: Article
• Language: English
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Atenolol; Atenolol - therapeutic use; Bayes Theorem; Complications and side effects; Correspondence; Dosage and administration; Evaluation; Humans; Hypertension - drug therapy; Hypertension - epidemiology; Meta-Analysis as Topic; Myocardial Infarction - epidemiology; Myocardial Infarction - prevention & control
• ISSN: 1472-6904; 1472-6904
• DOI: 10.1186/1472-6904-7-4

A recent meta-analysis of drug effects in patients with hypertension claims that all beta-adrenergic blockers are equally effective but less so than other antihypertensive drugs. Published comparisons of the beta-adrenergic blocker atenolol and non-atenolol beta-adrenergic blockers indicate different effects on death rates, arrhythmias, peripheral vascular resistance and prognosis post myocardial infarction, all in disfavor of atenolol. In keeping with these findings, the data presented in the meta-analysis indicate that atenolol is less effective than the non-atenolol beta-adrenergic blockers both when compared with placebo and with other antihypertensive drugs. These findings were not, however, statistically significant. We performed an additional analysis with a Bayesian statistical method in order to make further use of the published data. Our calculations on the clinical data in the meta-analysis showed 13% lower risk (risk ratio 0.87) of myocardial infarction among hypertensive patients taking non-atenolol beta-adrenergic blockers than among hypertensive patients taking atenolol. The 90 % credibility interval ranged from 0.75 to 0.99, thereby indicating statistical significance. The probability of at least 10% lower risk (risk ratio