Tenoretic

Can you learn anything new about a commonly prescribed drug that's been on the market for over three decades? Can a drug be good at lowering blood pressure without reducing heart attacks, stroke or cardiovascular deaths? Can a drug that is prescribed to prevent strokes cause strokes? The answer is yes to all three questions where it concerns atenolol, according to a review published in the British journal, The Lancet (11/6/04). Ironically, atenolol has long been the first choice drug prescribed to people with hypertension.

Lately we have been hearing about old drugs that are better than newer drugs--diuretics, for example. But here's a story of an old drug that's worse than some of its newer competitors. In an added twist, researchers had such confidence in atenolol that it had become the standard, against which newer drugs are compared in clinical trials.

33 Years in Use

The late-breaking news about the downside of atenolol, which is sold generically and under brand names, such as Tenoretic and Apo-Atenolol, came from a new review by a Swedish team of researchers. Over the years, according to the researchers, there had been questions raised about the wisdom of using atenolol as the comparator drug in clinical trials.

The Swedish researchers led by Bo Carlberg, MD, conducted a systematic review of all studies that looked specifically at atenolol's effect on heart-related death and complications in people with high blood pressure. They identified four trials that compared atenolol with a placebo (fake pill) or no treatment. And there were five more trials that compared atenolol with other antihypertensive drugs. Over 24,000 people, aged 60-74 years, participated in the nine trials that made up this review; they were followed for four to six years.

Here are the combined results of these trials:

-Atenolol was no better than a placebo in reducing deaths from all causes, cardiovascular deaths, heart attacks and strokes, though the drug was better at lowering blood pressure.

-When atenolol was compared with other antihypertensive drugs, there were no major differences in blood pressure lowering. There was, however, a significantly higher rate of deaths from all causes in the people taking atenolol, as well as a higher rate of cardiovascular mortality and stroke. The drugs against which atenolol was compared were losartan, captopril, lacidipine, and thiazide diuretics.

In an understated conclusion, Dr. Carlberg and colleagues wrote, "Our results cast doubts on atenolol as a suitable drug for hypertensive patients."

COPYRIGHT 2004 Center for Medical Consumers, Inc.
COPYRIGHT 2004 Gale Group