Critical appraissal: Should atenolol be the first choice for primary hypertension? Carlberg B, Samuelsson O, Lindholm L. Atenolol in hypertension: is it a wise choice? Lancet 2004; 364 : 1684-89

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dc.contributor.authorNeumann, I
dc.contributor.authorMontero, J
dc.date.accessioned2024-01-10T13:12:07Z
dc.date.available2024-01-10T13:12:07Z
dc.date.issued2005
dc.description.abstractBdckground: Atenolol is one of the most widely used beta blockers clinically, and has often been used as a reference drug in randomized controlled trials of hypertension. However questions have been raised about atenolol as the best reference drug for comparisons with other antihypertensives. Thus, our aim was to systematically review the effect of atenolol on cardiovascular morbidity and mortality in hypertensive patients. Methods. Reports were identified through searches of The Cochrane Library, MEDLINE, relevant textbooks, and by personal communication with established researchers in hypertension. Randomized controlled trials that assessed the effect of atenolol on cardiovascular morbidity or mortality in patients with primary hypertension were included. Findings. We identified four studies that compared atenolol with placebo or no treatment, and five that compared atenolol with other antihyperensive drugs. Despite major differences in blood pressure lowering, there were no outcome differences between atenolol and placebo in the four studies, comprising 6,825 patients, who were followed up for a mean of 4.6 years on all-cause mortality (relative risk 1.01 [95% Cl 0.89-1.15]), cardiovascular mortality (0.99 [0.83-1.18]), or myocardial infarction (0.99 [0.83-1.19]). The risk of stroke, however tended to be lower in the atenolol than in the placebo group (0.85 [0.72-1.01]). When atenolol was compared with other antihypertensives, there were no major differences in blood pressure lowering between the treatment arms. Our meta-analysis showed a significantly higher mortality (1.13 [1.02-1.25]) with atenolol treatment than with other active treatment, in the five studies comprising 17,671 patients who were followed up for a mean of 4.6 years. Moreover, cardiovascular mortality also tended to be higher with atenolol treatment than with other antihypertensive treatment. Stroke was also more frequent with atenolol treatment. Interpretation: Our results cast doubts on atenolol as a suitable drug for hypertensive patients. Moreover they challenge the use of atenolol as a reference drug in outcome trials in hypertension.
dc.format.extent4 páginas
dc.fuente.origenWOS
dc.identifier.issn0034-9887
dc.identifier.pubmedidMEDLINE:15970986
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/78141
dc.identifier.wosidWOS:000230070400013
dc.information.autorucMedicina;Montero J;S/I;98797
dc.issue.numero5
dc.language.isoes
dc.nota.accesoSin adjunto
dc.pagina.final600
dc.pagina.inicio597
dc.publisherSOC MEDICA SANTIAGO
dc.revistaREVISTA MEDICA DE CHILE
dc.rightsregistro bibliográfico
dc.subjectANTIHYPERTENSIVE THERAPIES
dc.subject1ST-LINE DRUG
dc.subjectBETA-BLOCKERS
dc.subjectMANAGEMENT
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleCritical appraissal: Should atenolol be the first choice for primary hypertension? Carlberg B, Samuelsson O, Lindholm L. Atenolol in hypertension: is it a wise choice? Lancet 2004; 364 : 1684-89
dc.typeartículo
dc.volumen133
sipa.codpersvinculados98797
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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