Reducing heart rate with beta blockers in hypertension is it harmful or Atenolol?
According to the Cardiology publication, which was published approximtely 1 year ago (J AM Coll Cardiology 52:1482).
Atenolol is the most popular and worst beta blocker currently prescribed,
and should not be a choice for anyone with hypertension.
Atenolol has fared the worse in comparison to some beta blockers, The researchers and doctors from St. Lukes Medical and other Major medical centers said that the Vasodilating beta blockers should be the only ones used if a beta blocker is the choice. Atenolol has been compared with one of the newer vasodilating beta blockers, Nebivolol (Bystolic), and it was found that atenolol increases the central aortic pressure but nebivolol does not.
The newer vasodilating beta blockers do not have any of these detrimental effects. Because they are vasodilatory, they may well offset the slowing of heart rate by decreasing cardiac wave reflection from the periphery and, in the case of nebivolol, by releasing nitric oxide, an endogenous vasodilator with antiatherogenic activity. Dr. Messerli states that if you need to take a beta blocker, please use a vasodilating one such as carvedilol or nebivolol.
He also states that Beta blockers in hypertension are not very useful, and you probably should use any other single drug first before you add a beta blocker.
What the newest research is showing is that slowing the heart rate with beta blockers in people with hypertension is associated with an increased risk of cardiovascular events and death. But experts point out the analysis was done mainly with studies that used atenolol and that it remains to be determined whether it is this drug or the reduction in heart rate that is harmful.
For patients with MI and heart failure, beta blockers are the best drugs. What the studies are showing is that in hypertension, when you slow down the heart rate with a beta blocker, it actually shortens your life expectancy, it causes more heart attacks, more heart failure, and more strokes. For hypertension only, the results are negative. Research shows that Atenolol, "has been tried and found guilty, and yet around 40% of prescriptions for beta blockers in the UK and in the US are still for atenolol. Atenolol should not be given to anybody. Nobody disagrees that atenolol is guilty, and yet we are still using it."
My opinion of this latest news is that it's possible that Atenolol is not the best drug for hypertension, but this does not prove that any other medications are better or safer. The number of patients on Atenolol is huge, possibly millions of people. I wonder how much of this article has to do with Pharmaceutical tainted MD's, who have a vested interest in promoting newer drugs or beta blockers. To think that a cheap generic drug (Atenolol), controls almost 50% of all prescriptions written worldwide, might motivate drug companies to discredit the drug to promote other newer brand medications. If Atenolol gains about another 15% of market share, it may very well force many Pharmaceutical companies into bankruptcy.