Circulation, Vol 64, 368-374, Copyright © 1981 by American Heart Association
MM Ibrahim and R Mossallam
Atenolol, a cardioselective beta-adrenergic blocking agent, was given as
the sole hypotensive drug for 8-12 weeks to 20 patients with hypertension
of varying degrees of severity. Initial systolic blood pressure ranged from
162-238 mm Hg (mean +/- SEM 196 +/- 5.5 mm Hg) and diastolic blood pressure
ranged from 105-143 mm Hg (118 +/- 2.5 mm Hg). Three patients had
accelerated hypertension, six had cardiomegaly with recent exertional
dyspnea and three were diabetics. Atenolol, 100-300 mg once daily,
controlled both the supine and standing blood pressure and markedly
attenuated the initial hypertensive response to severe exercise. In 17
patients (85%), atenolol therapy reduced blood pressure more than 20/10 mm
Hg; however, adequate blood pressure control was not achieved in severe
hypertension. A significant hypotensive action developed within 2 weeks of
treatment, and control of hypertension was maintained for 2 weeks after
sudden interruption of therapy. No patient had postural or postexercise
hypotension. The drug appeared to exert its maximum hypotensive effect at
the 100-mg dosage. The magnitude of the hypotensive response was related to
the initial systolic blood pressure (r = 0.77, p less than 0.01) and the
degree of inhibition of exercise tachycardia (r = 0.66, p less than 0.01).
The atenolol plasma level and its hypotensive action were not related.
Except for impairment of glucose tolerance in diabetic patients, atenolol
had minimal side effects.
ARTICLES
Clinical evaluation of atenolol in hypertensive patients
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