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Old 02-17-2010, 07:59 AM   #1
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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.

 
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Old 02-17-2010, 10:08 AM   #2
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Re: Reducing heart rate with beta blockers in hypertension is it harmful or Atenolol?

Quote:
Originally Posted by ACE28 View Post
... Dr. Messerli states that if you need to take a beta blocker, please use a vasodilating one such as carvedilol or nebivolol.
I vote for Carvedilol (Coreg)! It really keeps my blood pressure under control. It slows my heart rate, but I don't mind that at all.

Quote:
He also states that Beta blockers in hypertension are not very useful,
I realize that everyone is different, but Carvedilol, along with my very healthy diet, exercise and avoiding irritants, keeps my blood pressure at very health levels, and it is the only blood pressure med that I take.

The proof is in the pudding!

Quote:
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.
In clinical trials, Carvedilol has shown to improve the health of the heart and the patient.

Quote:
For patients with MI and heart failure, beta blockers are the best drugs.
An interesting contradiction. The research also showed that Beta Blockers "are associated with an increased risk of cardiovascular events and death"?!

Quote:
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.
In many large and small scale clinical trials, Carvedilol has shown to improve the health of the heart and the patient.

I really appreciate and enjoy the effects of Carvedilol on my Heart Failure, my Blood Pressure and my overall health. While this is strictly anecdotal on my part, I can't believe that I am the only one who is benefiting greatly from Carvedilol.

Quote:
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.
BINGO! An interesting point that could well be the explanation! Good point! Good insight on your part!

Thanks for producing another one of your interesting posts! Take care...
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⇒ Avoid allergic & non-allergic irritants/triggers
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Old 02-17-2010, 12:57 PM   #3
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Re: Reducing heart rate with beta blockers in hypertension is it harmful or Atenolol?

McMahon - Beta blockers are undisputed as the best treatment for heart failure and coronary Issues. The article questions the benefits when used for hypertension. The article also mentions that beta blockers are still very effective in men around 50 years old or younger. This is due to some hemodynamic effect in peripheral circualtion and pulse rates for younger men. The article appears to be an all out attack on Atenolol (mainly). As we know, not all beta blockers are created equal, and Carvedilol and Toprol are the only beta blockers currently approved for heart failure by the FDA. Most beta blockers were never tested for heart failure in clinical trials. With the exception of Bucindolol which showed almost no benefit in heart failure and Nebivolol which was effective but did not show such robust numbers, and Bisoprolol which is as effective as Toprol and Carvedilol but not yet approved in the U.S. only in the U.K.

The article mentions that amlodipine and perindopril were more effective then Atenolol and a diuretic on some end points. If any medication is combined with such a highly effective drug as Perindopril in huge clinical trials, the results would be very positive. If amlodipine was also combined with a diuretic, the results versus Atenolol would have been worse.

Once again, I beleive much of the attack on Atenolol is industry funded. It seems Atenolol is the most researched drug in over 800 clinical trials. It appears very easy to find many negative studies to smear the drug's
reputation. With all these research trials, their has to be some negatives. Their are many drugs that were never tested in Clinical trials, and some only tested once with a very short term trial and they are being prescribed everyday. I would rather take Atenolol if I had a choice among some newer untested drug. Because a pill was not found to be dangerous in only one study, does not prove that the pill is any better or worse than others.

 
Old 02-18-2010, 07:21 AM   #4
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Re: Reducing heart rate with beta blockers in hypertension is it harmful or Atenolol?

Hi - I agree with Macheon that Carvedilol is beneficial for hypertension without heart failure. My doctor specifically mentioned the fact that I do not have heart failure.
My cardiologist changed my prescription from Bystolic to Carvedilol 12.5mg to be taken twice a day. I am also taking other drugs , which I talk about in my thread on Tekturna.
My blood pressure has improved and is now under control for the first time in years.
I do have some stenosis in one of my kidneys. I know that Bystolic has worked for Ace and others; but the main thing I wanted to mention is that it is also prescribed for things other than heart failure without bad effects.

Last edited by hb-mod; 02-18-2010 at 09:17 AM. Reason: Removed Quote. Please use "Quick" Reply rather than "Quote" Reply. Thanks!

 
Old 02-18-2010, 07:43 AM   #5
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Re: Reducing heart rate with beta blockers in hypertension is it harmful or Atenolol?

Mabent - I'm glad to hear that Carvedilol is working for you. It seems some drugs can lose their effectiveness in controlling hypertension after awhile. This is why doctors are always increasing the dose. Some drugs are also more potent than others, and long term effectiveness is great. Atenolol has been prescribed for years to control high blood pressure, with good results.
I think this article is making patients and MD's think twice about Atenolol.

According to the latest beta blocker research, the best beta blockers to be taking are the vasodilating blockers, these include Carvedilol, Labetalol and Nebivolol. Your doctor was correct to suggest Carvedilol as an alternative for better blood pressure control. Your doctor seems to be "right on track" with the latest beta blocker studies..

Last edited by ACE28; 02-18-2010 at 07:45 AM.

 
Old 02-18-2010, 05:37 PM   #6
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Re: Reducing heart rate with beta blockers in hypertension is it harmful or Atenolol?

Thanks, Ace. I sure hope that all doctors will study thoroughly each drug to make sure it's the right one to give any particular patient and, if it proves not to be, will research thoroughly every drug he/she substitutes, especially the newer ones! Mabent

 
Old 02-19-2010, 07:42 AM   #7
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Re: Reducing heart rate with beta blockers in hypertension is it harmful or Atenolol?

Mabent - We have to hope that our doctors have our best interests in mind, and also the insights to see thru the negative controversial articles being published, and the pharmaceutical sales teams. When I mention to my doctor the news of recent drug controversies etc., he will respond almost 100% of time with the answer "That has not been proven". Smart doctors see through the hype. My doctor seems to base most of his approaches on 40 + yeaars of experience as a Cardiologist. When he tells me that Toprol XL is the best beta blocker in his many years of clinical experience, and Atenolol is a good substitute. I think the basis is proven experience. Yet, we read these negative articles on some of the beta blockers including Metoprolol, and we are left puzzled and worried. Yet, both Atenolol and Metoprolol have withstood the test of time, prescribed to millions of hypertensive patients since the 1960's and many are still alive. Will the newer pill's being pushed by the Pharm. Industry and the Media, prove their safety and effectiveness for more than 10 years, let alone 40 + years. As I mentioned in a previous topic, Bystolic (newest drug) was rejected recently by the FDA for heart failure indication, The mortality numbers were not robust enough, and did not show the effectiveness of Toprol XL in all areas studied. Bystolic is the newest recommended pill, which the Scientific journals and articles fully endorse, but yet it cannot be recommended at this time for anything other than high blood pressure. It's confusing. This is why, to a large degree, we need to adhere to our doctors recommendations, be honest and always keep him in the loop. My doctor is not against prescribing Bystolic or Carvedilol, (I'm currently on Bystolic) but his clinical experience favors Toprol XL.

Last edited by ACE28; 02-19-2010 at 07:45 AM.

 
Old 02-23-2010, 10:08 AM   #8
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Re: Reducing heart rate with beta blockers in hypertension is it harmful or Atenolol?

You know it is troubling when physicians are slow to realize that the drug they are using simply does not work. Atenolol is a perfect example . When used forhypertension it simply has not be show to prevent heart attacks or deaths compared to placebo. Yet it is still widely used. Why does it not work who knows it does not reduce central blood pressure as well as other drugs it causes diabetes it causes weight gain it does reduce blood pressure inthe arm a little. The fact that people use this drug and many are alive really does not say much the they would be alive anyway. It would be difficult to find a hypertension expert who would recommend this drug. Why it simoly does not work very well.

 
Old 02-24-2010, 06:48 PM   #9
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Re: Reducing heart rate with beta blockers in hypertension is it harmful or Atenolol?

I still believe certain beta blockers and ace inhibitors are the best of the bunch. They are approved for the most indications, from hypertension to heart failure. Diuretics deplete many essential minerals and Calcium Blockers
have never been shown to improve mortality in the few large studies conducted. According to many cardiologists and alternative doctors, beta blockers prevent MI especially in the morning hours when Mi's are more frequent, upon waking the normal heart rate can greatly increase to dangerous levels, and especially if added stress or anxiety is part of the morning routine. Beta blockers decrease that dangerous surge of adrenaline.

 
Old 02-25-2010, 08:37 AM   #10
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Re: Reducing heart rate with beta blockers in hypertension is it harmful or Atenolol?

Atenolol in particular does not appear to be an effective drug when used to treat hypertension. A study "Atenolol in hypertension: is it a wise choice. published in the Lancet 2004 found that Atenolol was no better than placebo at preventing MI; Deaths,or cardiovascular mortality when compared to placebo when compared other anti hypertensive medications the atenolol group had higher rates of death'; cardiovascular mortality ;and stroke.

 
Old 02-25-2010, 10:58 AM   #11
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Re: Reducing heart rate with beta blockers in hypertension is it harmful or Atenolol?

Quote:
Originally Posted by mabent View Post
Hi - I agree with Machaon that Carvedilol is beneficial for hypertension without heart failure. My doctor specifically mentioned the fact that I do not have heart failure.
Carvedilol is the most effective, longest lasting and most beneficial Beta Blocker on the market for many different health and heart problems, including High Blood Pressure.

OTOH, Heart Failure doesn't usually cause High Blood Pressure, it's the other way around: High Blood Pressure causes Heart Failure, so it makes sense that Carvedilol would be effective against High Blood Pressure, whether one has Heart Failure or not.

The problem with Carvedilol, or Atenolol, or any other heart medication is that Beta Blockers, and other heart medications, only treat the symptoms, not the underlying cause of the affliction. As long as the cause of the heart disease is not remedied, the health problems will only continue to get worse, slowly resulting in the need for increased dosages of the medications until they become no longer effective.
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⇒ Avoid allergic & non-allergic irritants/triggers
⇒ Low calorie ovo-vegetarian diet
⇒ Power walk, weight lifts, pushups
⇒ Coreg 25mg bid

Last edited by Machaon; 02-25-2010 at 11:10 AM.

 
Old 02-26-2010, 08:46 AM   #12
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Re: Reducing heart rate with beta blockers in hypertension is it harmful or Atenolol?

Quote:
Originally Posted by bigvince1 View Post
Atenolol in particular does not appear to be an effective drug when used to treat hypertension. A study "Atenolol in hypertension: is it a wise choice. published in the Lancet 2004 found that Atenolol was no better than placebo at preventing MI; Deaths,or cardiovascular mortality when compared to placebo when compared other anti hypertensive medications the atenolol group had higher rates of death'; cardiovascular mortality ;and stroke.
I'm not trying to be an advocate for Atenolol, but which drug really is effective for preventing Cardiovascular issues? The articles use Atenolol to bash all beta-blockers, and it's really not fair. The articles never mention that long term use of the many other classes of HBP drugs are either unknown, or known to cause Kidney failure, stroke, MI, and liver failure. In a study reported by the BMJ, The ARB Diovan (also one of the post popular drugs)was shown to greatly increase the heart attack risk, when compared to Ace Inhibitors. Does this apply to all ARB'S??? Who knows.... Is it safer than Atenolol??

 
Old 02-26-2010, 08:52 AM   #13
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Re: Reducing heart rate with beta blockers in hypertension is it harmful or Atenolol?

Machaon - You are a very strong advocate for Carvedilol, and for very good reason. You've seen great improvements and feel better. Do you take the brand name drug COREG? or the generic Carvedilol?? Their is also an Extended Release Version Available....

 
Old 02-26-2010, 10:41 AM   #14
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Re: Reducing heart rate with beta blockers in hypertension is it harmful or Atenolol?

Quote:
Originally Posted by ACE28 View Post
Machaon - You are a very strong advocate for Carvedilol, and for very good reason. You've seen great improvements and feel better.
Your are correct about the effects of Coreg on my health. But, the reason why I asked my Cardiologist to write me a prescription for Coreg was because of the 58 +/- clinical trials for which I have spent much time reading; plus many other articles extolling the virtues of Coreg. The more that I read about Coreg, the more that I was amazed by it's unique and powerful ability to improve one's Blood Pressure, Heart Failure, Heart Disease and many other health problems. It's kinda a health elixir. I love it!

Quote:
Do you take the brand name drug COREG? or the generic Carvedilol??
Carvedilol! It's $4 for a month's supply, $10 for three months. Cheap! Cheaper! Cheapest!

In these days of high cost medical care, it costs me very little to care and greatly improve my Heart Failure, High Blood Pressure, Permanent Atrial Fibrillation, Valve Disease and overall health. At one time I wasn't sure that I was going to live to 60. At this time, I am not sure that I can survive these nasty health problems to 80, but as long as my health is improving, and I've got a good quality of life, there's hope.

Quote:
Their is also an Extended Release Version Available....
There is absolutely no benefit to the Extended Release Version, IMHO. The old, original Coreg has been thoroughly tested once per day, and twice per day, and it does just fine either way, as per my reading of the clinical trials.
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CHF, A-Fib, HBP, Diabetes, Asthma doing great

⇒ Avoid allergic & non-allergic irritants/triggers
⇒ Low calorie ovo-vegetarian diet
⇒ Power walk, weight lifts, pushups
⇒ Coreg 25mg bid

Last edited by Machaon; 02-26-2010 at 04:59 PM.

 
Old 02-26-2010, 06:32 PM   #15
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Re: Reducing heart rate with beta blockers in hypertension is it harmful or Atenolol?

Machaon - Focus on the 100 mark (God Willing). Remember 100 is the new 80.

 
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