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Environmental Toxicology and... Sep 2023Blood pressure medications like atenolol are detected in aquatic ecosystems. The objectives here were to (1) map the global presence of atenolol in surface water and... (Review)
Review
Blood pressure medications like atenolol are detected in aquatic ecosystems. The objectives here were to (1) map the global presence of atenolol in surface water and sewage; (2) present current knowledge regarding removal efficiency and degradation of atenolol; (3) identify biological endpoints sensitive to exposure; (4) reveal molecular biomarkers that may be useful for exposure studies in fish; (5) determine whether toxicology studies are within environmental relevance. In fish, atenolol exposure affects endocrine and immune systems, metabolism, and epigenetics. Fewer than half of all studies measuring biological responses use environmentally-relevant concentrations. Heart rate appeared most sensitive to atenolol exposure relative to other endpoints. Data are lacking for behavioral responses to atenolol. Molecular biomarkers for atenolol may include those associated with acute kidney injury, cholestasis, and hypertriglyceridemia. Head kidney and liver may therefore be useful for detecting atenolol-induced effects. This review synthesizes knowledge regarding atenolol-induced toxicity in fish.
Topics: Animals; Atenolol; Ecosystem; Fishes; Biomarkers
PubMed: 37481051
DOI: 10.1016/j.etap.2023.104236 -
Drugs Sep 1991Atenolol is a selective beta 1-adrenoceptor antagonist with a duration of activity of at least 24 hours. The scope of therapeutic use of the drug has been expanded and... (Review)
Review
Atenolol is a selective beta 1-adrenoceptor antagonist with a duration of activity of at least 24 hours. The scope of therapeutic use of the drug has been expanded and become better defined since it was first reviewed in the Journal in 1979. Atenolol is effective and generally well tolerated in patients with all grades of hypertension. Data from comparative studies show that when administered orally, atenolol reduces blood pressure to a similar extent, and in a similar proportion of patients, as usual therapeutic doses of other beta-adrenoceptor antagonists (such as acebutolol, celiprolol, betaxolol, indenolol, metoprolol, nadolol, pindolol, propranolol, tertatolol), angiotensin converting enzyme (ACE) inhibitors (e.g. captopril, enalapril and lisinopril), calcium antagonists (e.g. amlodipine, diltiazem, felodipine, isradipine, nitrendipine, nifedipine, verapamil), doxazosin, ketanserin and alpha-methyldopa. Atenolol effectively lowers blood pressure in elderly patients with hypertension and in women with hypertension associated with pregnancy, and improves objective and subjective indices in patients with stable angina pectoris. Oral atenolol is used for preventing recurrence of supraventricular arrhythmias once control is achieved by intravenous administration of atenolol. Early intervention with intravenous atenolol followed by oral maintenance therapy reduces infarct recurrence and cardiovascular mortality in patients with known or suspected myocardial infarction. There is also encouraging evidence of reduced mortality from cardiovascular disease during long term therapy with atenolol in patients with hypertension. Atenolol is well tolerated in most patients. Increases in plasma levels of both total triglycerides and very low density lipoprotein (VLDL) triglycerides have accompanied atenolol therapy although the clinical relevance, if any, of longer term metabolic effects has yet to be determined. Its low lipid solubility and limited brain penetration results in a lower incidence of central nervous system effects than that associated with propranolol. After many years of clinical usage atenolol is a well established treatment option in several areas of cardiovascular medicine such as mild to moderate hypertension and stable angina pectoris. Furthermore, it has also shown potential in the treatment of some cardiac arrhythmias and has been associated with reduced cardiovascular mortality in patients with hypertension and in patients with myocardial infarction.
Topics: Arrhythmias, Cardiac; Atenolol; Coronary Disease; Drug Evaluation; Humans; Hypertension
PubMed: 1720383
DOI: 10.2165/00003495-199142030-00007 -
Drugs Jun 1979Atenolol is a beta-selective (cardioselective) adrenoceptor blocking drug without partial agonist or membrane stabilising activity. Its profile of action most closely... (Review)
Review
Atenolol is a beta-selective (cardioselective) adrenoceptor blocking drug without partial agonist or membrane stabilising activity. Its profile of action most closely resembles that of metoprolol which differs only in that it has some membrane stabilising activity. Atenolol has been well studied and is effective in the treatment of hypertension and in the prophylactic management of angina. Its narrow dose response range obviates the need for highly individualised dose titration. In patients with angina its long duration of beta-blocking activity allows once daily dosage, whereas other beta-blockers, unless in sustained release dosage forms, need to be given in divided doses. Other beta-blockers can be given once daily in hypertension, but at presnt the evidence for effective control with a once daily regimen is more convincing with atenolol. Further studies are need to clarify any important differences in blood pressure control between the various beta-blocking drugs, both in conventional or sustained release dosage forms. As with metoprolol, atenolol is preferable to non-selective beta-blockers in patients with asthma or diabetes mellitus. Atenolol has been well tolerated in most patients, its profile of adverse reactions generally resembling that of other beta-blocking drugs, although its low lipid solubility and limited penetration into the brain results in a lower incidence of central nervous system effects than seen with propranolol. Atenolol is eliminated virtually entirely as unchanged drug in the urine and dosage needs to be reduced in patients with moderate to severely impaired renal function (glomerular filtration rate less than 30 ml/min). There is no need for modification of dosage of atenolol in liver disease.
Topics: Adrenergic beta-Antagonists; Angina Pectoris; Animals; Atenolol; Central Nervous System; Hemodynamics; Humans; Hypertension; Kinetics; Metabolism; Propanolamines; Renin; Respiration
PubMed: 38096
DOI: 10.2165/00003495-197917060-00001 -
European Journal of Drug Metabolism and... 1982Atenolol is a hydrophilic betareceptor blocking drug, which is predominantly eliminated via the kidneys, only about 5% of the atenolol is metabolised by the liver. After... (Review)
Review
Atenolol is a hydrophilic betareceptor blocking drug, which is predominantly eliminated via the kidneys, only about 5% of the atenolol is metabolised by the liver. After oral administration atenolol is incompletely absorbed from the intestine, so about 50% of the beta blocker are finally biovailable. In plasma only 3% of atenolol are protein-bound. There exists a linear relationship between the atenolol plasma levels and the degree of beta blocking effect measured by inhibition of the exercise-induced tachycardia. No correlation was found between plasma levels of atenolol and blood pressure lowering activity of the drug. After oral administration elimination half life of atenolol is calculated from 6 to 9 h by different authors. In patients with impaired renal function elimination half life of atenolol gradually increases to values of 36 h in uraemic patients (glomerular filtration rate (GFR) less than 10 ml/min). Between GFR and atenolol plasma clearance as well as renal clearance a close significant correlation is described. Prolongation of elimination half life requires a dosage adjustment of atenolol in patients with renal failure. A marked interaction of atenolol is found when calcium or aluminium hydroxide are concurrently administered with the beta blocker whereas cimetidine does not influence atenolol kinetics.
Topics: Administration, Oral; Atenolol; Biological Availability; Drug Interactions; Humans; Injections, Intravenous; Intestinal Absorption; Kidney; Kidney Diseases; Kinetics; Liver Diseases; Propanolamines; Renal Dialysis
PubMed: 6749509
DOI: 10.1007/BF03188723 -
Clinical and Experimental Hypertension... 2017This meta-analysis of randomized parallel controlled trials was designed to compare the efficacy of atenolol with angiotensin-converting enzyme inhibitors (ACEIs) in... (Comparative Study)
Comparative Study Meta-Analysis Review
A meta-analytical comparison of atenolol with angiotensin-converting enzyme inhibitors on arterial stiffness, peripheral blood pressure and heart rate in hypertensive patients.
OBJECTIVES
This meta-analysis of randomized parallel controlled trials was designed to compare the efficacy of atenolol with angiotensin-converting enzyme inhibitors (ACEIs) in changing pulse wave velocity (PWV), peripheral blood pressure and heart rate (HR) among patients with essential hypertension.
METHODS
This study was conducted according to the PRISMA guideline. Data collection was independently completed by two investigators. Statistical analyses were completed by Stata software (v12.0).
RESULTS
Eight clinical trials were meta-analyzed in this study. Overall changes in PWV (weighted mean difference or WMD = 0.068, 95% confidence interval or CI: -0.487 to -0.623, P = 0.811) and peripheral systolic blood pressure (PSBP) (WMD = -1.281 mmHg, 95% CI: -6.936 to 4.375, P = 0.657) did not differ significantly between atenolol and ACEIs treatment. Relative to ACEIs, atenolol had a more favorable impact on peripheral diastolic blood pressure (PDBP) (WMD = -1.912 mmHg, 95% CI: -3.732 to -0.091, P = 0.040) and HR (WMD = -9.23 bpm, 95% CI: -12.53 to -5.93, P < 0.001). In stratified analyses, particularly by follow-up period, atenolol was observed to be superior over ACEIs within early 3-month treatment in PSBP (WMD = -4.097 mmHg, 95% CI: -6.589 to -1.605, P = 0.001), PDBP (WMD = -6.802 mmHg, 95% CI: -8.517 to -5.087, P < 0.001) and HR (WMD = -14.242 bpm, 95% CI: -16.427 to -12.058, P = 0.028), without heterogeneity (I = 0.0%). There were low probabilities of publication bias for all comparisons.
CONCLUSIONS
Our findings demonstrate that atenolol and ACEIs were equally effective in reducing PWV and PSBP, while atenolol was superior over ACEIs in improving PDBP and HR, especially within short-term treatment.
Topics: Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Atenolol; Blood Pressure; Heart Rate; Humans; Hypertension; Pulse Wave Analysis; Randomized Controlled Trials as Topic; Vascular Stiffness
PubMed: 28534649
DOI: 10.1080/10641963.2016.1267188 -
Current Medical Research and Opinion 1991Data generated to date on the use of beta-blockers, especially atenolol, in ischaemic heart disease are reviewed and compared with the results available with the calcium... (Review)
Review
Data generated to date on the use of beta-blockers, especially atenolol, in ischaemic heart disease are reviewed and compared with the results available with the calcium antagonists. Atenolol appears to be effective as an anti-ischaemic agent in patients with obstructive coronary artery disease when reduction in myocardial oxygen supply (ischaemia not preceded by an increase in heart rate and due presumably to functional coronary stenosis) or increase in demand are the likely causes. Based on current concepts and available data, there is convincing evidence to support the use of atenolol across the spectrum of ischaemic heart disease. In contrast, results with the calcium antagonists have been disappointing and variable. Atenolol, to date, is the only beta-blocker which has been demonstrated to have a life-saving benefit in acute intervention (within 12 hours of onset) in myocardial infarction. This cardioprotective aspect of the drug is likely to be applicable to other areas of ischaemic heart disease, including silent ischaemia.
Topics: Atenolol; Cause of Death; Circadian Rhythm; Clinical Trials as Topic; Coronary Disease; Humans; Myocardial Infarction
PubMed: 1764953
DOI: 10.1185/03007999109111659 -
The New England Journal of Medicine Nov 1982
Clinical Trial
Topics: Adult; Aged; Atenolol; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Propanolamines; Timolol
PubMed: 6752713
DOI: 10.1056/NEJM198211183072116 -
The New England Journal of Medicine Jun 1982
Review
Topics: Arrhythmias, Cardiac; Atenolol; Coronary Disease; Humans; Hypertension; Kinetics; Propanolamines; Timolol
PubMed: 7043268
DOI: 10.1056/NEJM198206173062404 -
British Journal of Clinical Pharmacology Oct 19771 The effect of atenolol, a cardioselective beta adrenoceptor antagonist, was studied in a double-blind crossover trial in twenty-one carefully selected hypertensive... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
1 The effect of atenolol, a cardioselective beta adrenoceptor antagonist, was studied in a double-blind crossover trial in twenty-one carefully selected hypertensive outpatients. Each patient received atenolol (50 mg/day, 100 mg/day, 200 mg/day) and placebo according to a randomized sequence in a once-daily dose. Wash-out periods on a matching placebo were included between the treatment periods. 2 The effect of lying, standing and post-exercise blood pressure of atenolol 50 mg once-daily was not significantly different from atenolol 100 or 200 mg once-daily. The reduction in lying and standing blood pressure was approximately 23/16 and 22/18 mm Hg from levels at the end of a run-in period on matching placebo of 167/108 and 162/112 mm Hg respectively. 3 The study shows that atenolol is an effective hypotensive agent in a once-daily dose.
Topics: Adult; Atenolol; Clinical Trials as Topic; Drug Administration Schedule; Hemodynamics; Humans; Hypertension; Male; Propanolamines; Time Factors
PubMed: 334211
DOI: 10.1111/j.1365-2125.1977.tb00780.x -
Reproductive Toxicology (Elmsford, N.Y.) 2002
Comparative Study Review
Topics: Adrenergic beta-Antagonists; Animals; Animals, Newborn; Antihypertensive Agents; Atenolol; Embryonic and Fetal Development; Female; Humans; Infant, Newborn; Maternal-Fetal Exchange; Pregnancy
PubMed: 11934527
DOI: 10.1016/s0890-6238(01)00193-9