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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 -
Vascular Pharmacology Oct 2022The mechanisms underlying the success of propranolol in the treatment of infantile hemangioma (IH) remain elusive and do not fully explain the rapid regression of...
UNLABELLED
The mechanisms underlying the success of propranolol in the treatment of infantile hemangioma (IH) remain elusive and do not fully explain the rapid regression of hemangiomatous lesions following drug administration. As autophagy is critically implicated in vascular homeostasis, we determined whether β-blockers trigger the autophagic flux on infantile hemangioma-derived endothelial cells (Hem-ECs) in vitro.
MATERIAL AND METHODS
Fresh tissue specimens, surgically removed for therapeutic purpose to seven children affected by proliferative IH, were subjected to enzymatic digestion. Cells were sorted with anti-human CD31 immunolabeled magnetic microbeads. Following phenotypic characterization, expanded Hem-ECs, at P2 to P6, were exposed to different concentrations (50 μM to 150 μM) of propranolol, atenolol or metoprolol alone and in combination with the autophagy inhibitor Bafilomycin A1. Rapamycin, a potent inducer of autophagy, was also used as control. Autophagy was assessed by Lysotracker Red staining, western blot analysis of LC3BII/LC3BI and p62, and morphologically by transmission electron microscopy.
RESULTS
Hem-ECs treated with either propranolol, atenolol or metoprolol displayed positive LysoTracker Red staining. Increased LC3BII/LC3BI ratio, as well as p62 modulation, were documented in β-blockers treated Hem-ECs. Abundant autophagic vacuoles and multilamellar bodies characterized the cytoplasmic ultrastructural features of autophagy in cultured Hem-ECs exposed in vitro to β-blocking agents. Importantly, similar biochemical and morphologic evidence of autophagy were observed following rapamycin while Bafilomycin A1 significantly prevented the autophagic flux promoted by β-blockers in Hem-ECs.
CONCLUSION
Our data suggest that autophagy may be ascribed among the mechanisms of action of β-blockers suggesting new mechanistic insights on the potential therapeutic application of this class of drugs in pathologic conditions involving uncontrolled angiogenesis.
Topics: Adrenergic beta-Antagonists; Amines; Atenolol; Autophagy; Cell Proliferation; Child; Endothelial Cells; Hemangioma; Humans; Macrolides; Metoprolol; Propranolol; Sirolimus
PubMed: 36103993
DOI: 10.1016/j.vph.2022.107110 -
International Journal of Cardiology Apr 2010ASCOT-BPLA study demonstrates that in hypertensive subjects, atenolol+bendroflumethiazide therapy is associated with higher incidence of adverse cardiovascular outcomes... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
ASCOT-BPLA study demonstrates that in hypertensive subjects, atenolol+bendroflumethiazide therapy is associated with higher incidence of adverse cardiovascular outcomes and developing diabetes than an amlodipine+perindopril regimen. This is not explained by changes in blood pressure alone. We hypothesized that distinct vascular and metabolic effects of anti-hypertensive drugs may explain these differential effects.
METHODS
Either placebo or one class of anti-hypertensive drug (atenolol 100 mg, amlodipine 10 mg, hydrochlorothiazide 50 mg, ramipril 10 mg, or candesartan 16 mg) was given daily during 8 weeks to 31 patients in each of 6 arms of a randomized, single-blind, placebo-controlled, parallel study.
RESULTS
Atenolol, amlodipine, and candesartan therapies significantly reduced systolic blood pressure when compared with ramipril (P<0.05 by ANOVA). Atenolol and thiazide therapies increased triglycerides levels greater than ramipril or candesartan (P=0.005 by ANOVA). Amlodipine significantly increased HDL cholesterol levels greater than atenolol (P=0.011 by ANOVA). Ramipril and candesartan therapies improved FMD and increased adiponectin levels and insulin sensitivity to a greater extent than atenolol or thiazide therapies (P<0.001 and P<0.015 by ANOVA). Amlodipine therapy increased adiponectin levels greater than atenolol therapy (P<0.05 by ANOVA). Ramipril, candesartan, and amlodipine therapies significantly decreased leptin levels to a greater extent when compared with atenolol or thiazide therapies (P<0.001 by ANOVA). Amlodipine therapies significantly decreased resistin levels greater than ramipril or candesartan therapies (P=0.001 by ANOVA).
CONCLUSIONS
We observed differential effects of anti-hypertensive drugs on endothelial dysfunction and plasma adipocytokines.
Topics: Adipokines; Adiponectin; Adult; Aged; Amlodipine; Antihypertensive Agents; Atenolol; Benzimidazoles; Biphenyl Compounds; Cholesterol, HDL; Comorbidity; Endothelium, Vascular; Female; Humans; Hypertension; Male; Middle Aged; Ramipril; Single-Blind Method; Tetrazoles; Triglycerides
PubMed: 19059660
DOI: 10.1016/j.ijcard.2008.11.017 -
Daru : Journal of Faculty of Pharmacy,... Dec 2022Affordable access to quality medicines is a critical target of global efforts to achieve universal health coverage. The aim of this study is to measure the affordability...
PURPOSE
Affordable access to quality medicines is a critical target of global efforts to achieve universal health coverage. The aim of this study is to measure the affordability and accessibility of cardiovascular medicines in the city of Herat, Afghanistan.
METHODS
The price, affordability, and availability data for 18 most sold generic (MSG) and lowest priced generic (LPG) products were collected from public and private pharmacies located in Herat city in Afghanistan in 2020, which in each area, six pharmacies were randomly selected from a combination of public and private ones based on the standardized methodology developed by WHO/HAI. According to this methodology on Medicine Prices, Accessibility, and Affordability, the minimum daily wage of an unskilled governmental worker, and the price of each type of cardiovascular medicines for one-month use were calculated separately. If the cost of the treatment was more than the minimum daily wage, the medicine was considered unaffordable.
RESULTS
The mean availability score for lowest price generic (LPG) in public and private pharmacies and based on the countries of origin including Iran, Pakistan, and India was 60%, 46%, and 31%, respectively. Of the 18 medicines surveyed, just Atenolol (Iranian brand) was found in all 30 pharmacies on the day of data collection. All Indian- brand medicines were less than fifty percent available in any of the surveyed public and private pharmacies. Among the medicines exported to Afghanistan, the population of Herat used more medicines made by Pakistan compared to India and Iran (MSG). Indian medicines were the most expensive ones and the Iranian medicines were the cheapest. A wage of less than one day was enough to afford one-month supply of generic medicines at the lowest price.
CONCLUSION
Access of patients to cardiovascular medicines in Afghanistan was 46% in this study which is regarded as low access. Most of available cardiovascular medicines in the market of this country were made in Iran, Pakistan and India. Although the Iranian ones were the cheapest, but people used more Pakistani medicines. LPG products were affordable to the studied population.
Topics: Humans; Afghanistan; Atenolol; Costs and Cost Analysis; Iran
PubMed: 36385235
DOI: 10.1007/s40199-022-00454-8 -
British Journal of Clinical Pharmacology Dec 19911. Maximal aerobic exercise capacity, submaximal endurance exercise performance, and exercise haemodynamics have been studied in sixteen patients with mild to moderate... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
1. Maximal aerobic exercise capacity, submaximal endurance exercise performance, and exercise haemodynamics have been studied in sixteen patients with mild to moderate essential hypertension during treatment with captopril and atenolol. 2. Administration of atenolol (1 x 100 mg day-1) or captopril (1 x 100 mg day-1) for 6 weeks resulted in similar supine and erect systolic and diastolic blood pressures. Heart rate was significantly lower during atenolol treatment. 3. Exercise heart rate and systolic blood pressure were significantly lower during atenolol than during captopril treatment, exercise diastolic blood pressure (at 100W) did not differ significantly. With atenolol exercise cardiac output was significantly lower and exercise stroke volume significantly higher than with captopril. 4. Maximal work rate, maximal oxygen consumption and maximal heart rate were significantly lower during atenolol than during captopril treatment (respectively 6%, 8% and 25%). Maximal respiratory exchange ratio and lactate concentration did not differ. 5. No statistically significant difference in submaximal endurance time between atenolol and captopril was found. Endurance time was reduced by 19% during atenolol and by 13% during captopril as compared with placebo. No difference in rating of perceived exertion between atenolol and captopril was present. 6. The results indicate that atenolol will reduce blood pressure during exercise more effectively than captopril in patients with hypertension. The limitation of submaximal endurance exercise performance by both agents is of similar magnitude. This may be regarded as an unwanted side effect in certain physically active patients with hypertension.
Topics: Atenolol; Captopril; Double-Blind Method; Exercise; Hemodynamics; Humans; Hypertension; Male; Middle Aged; Oxygen Consumption; Pulmonary Gas Exchange
PubMed: 1768565
DOI: No ID Found -
British Journal of Clinical Pharmacology Dec 19811 In an open, randomized cross-over investigation of thirteen patients (nine and four women, aged 37-67 years) with mild or moderate essential hypertension a comparison... (Clinical Trial)
Clinical Trial Comparative Study
1 In an open, randomized cross-over investigation of thirteen patients (nine and four women, aged 37-67 years) with mild or moderate essential hypertension a comparison between atenolol and metoprolol was carried out in order to study the effects of 50, 100 and 200 mg given once daily on blood pressure and heart rate at rest and during exercise. 2 Before one beta-adrenoceptor blocking drug was replaced by the other in a patient an intervening drug-free interval of sufficient length was secured to allow an increase in the blood pressure to pretreatment levels. 3 A maximal fall in blood pressure was achieve with 50 mg atenolol once daily, with no further reduction when the dose was increased to 100 mg or 200 mg. Maximal blood pressure reduction was achieved with 100 mg metoprolol daily, while the hypertensive effect of 50 mg once daily was not consistent. Significant reductions in heart rate in all test situations were observed with 50 mg atenolol, while 200 mg metoprolol 100 was necessary to reduce exercise-induced tachycardia. 4 Atenolol 50 mg and metoprolol 100 mg once daily are efficient in treating mild or moderate hypertension and doses beyond these may not reduce the blood pressure further. On the contrary lower doses than generally recommended may be effective in the individual patient.
Topics: Adult; Aged; Atenolol; Blood Pressure; Creatinine; Female; Heart Rate; Humans; Hypertension; Male; Metoprolol; Middle Aged; Physical Exertion; Propanolamines; Time Factors
PubMed: 7340890
DOI: 10.1111/j.1365-2125.1981.tb01326.x -
Journal of the American College of... Mar 1995This study compared the effects of amlodipine, atenolol and their combination on ischemia during treadmill testing and 48-h ambulatory monitoring. (Clinical Trial)
Clinical Trial Randomized Controlled Trial
Effect of amlodipine, atenolol and their combination on myocardial ischemia during treadmill exercise and ambulatory monitoring. Canadian Amlodipine/Atenolol in Silent Ischemia Study (CASIS) Investigators.
OBJECTIVES
This study compared the effects of amlodipine, atenolol and their combination on ischemia during treadmill testing and 48-h ambulatory monitoring.
BACKGROUND
It is not known whether anti-ischemic drugs exert similar effects on ischemia during ambulatory monitoring and exercise treadmill testing.
METHODS
Patients with stable coronary artery disease and ischemia during treadmill testing and ambulatory monitoring were randomized to receive amlodipine (n = 51) or atenolol (n = 49). Each group underwent a counterbalanced, crossover evaluation of single drug and placebo, followed by evaluation of the combination.
RESULTS
Amlodipine and the combination prolonged exercise time to 0.1-mV ST segment depression by 29% and 34%, respectively (p < 0.001) versus 3% for atenolol (p = NS). During ambulatory monitoring, the frequency of ischemic episodes decreased by 28% with amlodipine (p = 0.083 [NS]), by 57% with atenolol (p < 0.001) and by 72% with the combination (p < 0.05 vs. both single drugs; p < 0.001 vs. placebo). Suppression of ischemia during exercise testing and ambulatory monitoring was similar in patients with and without exercise-induced angina. Exercise time to angina improved by 29% with amlodipine (p < 0.01), by 16% with atenolol (p < 0.05) and by 39% with the combination (p < 0.005 vs. placebo, atenolol and amlodipine). In patients with angina, total exercise time improved by 16% with amlodipine (p < 0.001), by 4% with atenolol (p = NS) and by 19% with the combination (p < 0.05 vs. placebo and either single drug). In those patients without angina, no therapy significantly improved total exercise time.
CONCLUSIONS
Ischemia during treadmill testing was more effectively suppressed by amlodipine, whereas ischemia during ambulatory monitoring was more effectively suppressed by atenolol. The combination was more effective than either single drug in both settings.
Topics: Amlodipine; Atenolol; Cross-Over Studies; Drug Therapy, Combination; Electrocardiography, Ambulatory; Exercise Test; Female; Hemodynamics; Humans; Male; Middle Aged; Myocardial Ischemia; Time Factors
PubMed: 7860905
DOI: 10.1016/0735-1097(94)00436-t -
BMJ (Clinical Research Ed.) Mar 1993To assess incidence of and mortality from cancer in hypertensive patients taking atenolol, comparing the findings with two control populations and with hypertensive... (Comparative Study)
Comparative Study
OBJECTIVES
To assess incidence of and mortality from cancer in hypertensive patients taking atenolol, comparing the findings with two control populations and with hypertensive patients taking other drugs.
DESIGN
Retrospective analysis of patients first seen in the Glasgow Blood Pressure Clinic between 1972 and 1990. Patients' records were linked with the registrar general's data for information on mortality and with the West of Scotland Cancer Registry for information on incident and fatal cancers. Cancers were compared in patients and controls and in patients taking atenolol, beta blockers other than atenolol, and hypotensive drugs other than beta blockers.
SUBJECTS
6528 male and female patients providing 54,355 years of follow up.
SETTING
Hypertension clinic in Glasgow.
MAIN OUTCOME MEASURES
Observed numbers of cancers in clinic patients were compared with expected numbers derived from cancer rates in two control populations adjusted for age, sex, and time period of data collection.
RESULTS
Cancer mortality was not significantly different in clinic patients as a whole and controls. Incident and fatal cancers were not significantly increased in male or female patients taking atenolol. Cancer incidence did not rise in the clinic after a large increase in prescriptions for atenolol after 1976.
CONCLUSION
This analysis does not suggest a link between atenolol and cancer.
Topics: Age Factors; Antihypertensive Agents; Atenolol; Female; Humans; Hypertension; Incidence; Male; Middle Aged; Neoplasms; Registries; Retrospective Studies; Scotland; Sex Factors; Smoking; Time Factors
PubMed: 8461810
DOI: 10.1136/bmj.306.6878.609 -
British Heart Journal Mar 1986The antianginal effects of nifedipine 20 mg three times a day and atenolol 100 mg once a day singly and in combination were investigated in 16 patients with angina... (Clinical Trial)
Clinical Trial
The antianginal effects of nifedipine 20 mg three times a day and atenolol 100 mg once a day singly and in combination were investigated in 16 patients with angina pectoris. The amount of work that could be done before angina and ST depression appeared was significantly increased by atenolol and the combination but not by nifedipine. At peak exercise the number of leads on a 16 point precordial electrocardiogram map that demonstrated greater than or equal to 1 mm ST segment depression was significantly reduced from a mean (SD) of 5.0 (0.4) on placebo to 3.7 (0.6), 2.8 (0.4), and 2.3 (0.7) on nifedipine, atenolol, and the combination respectively. Mean resting left ventricular ejection fraction, assessed by gated radionuclide ventriculography, did not change during any active treatment phase but increased significantly during exercise only on nifedipine and the combination. The nifedipine/atenolol combination was the most effective treatment, and the data suggest that nifedipine may be used to best advantage in combination with a beta blocker.
Topics: Angina Pectoris; Atenolol; Drug Therapy, Combination; Humans; Male; Middle Aged; Nifedipine; Nitroglycerin; Physical Exertion; Stroke Volume
PubMed: 3082344
DOI: 10.1136/hrt.55.3.240 -
Journal of Veterinary Internal Medicine May 2022Beta-blockade is sometimes used in dogs with pulmonic stenosis with the intent of reducing frequency of ventricular arrhythmias during right heart catheterization.
BACKGROUND
Beta-blockade is sometimes used in dogs with pulmonic stenosis with the intent of reducing frequency of ventricular arrhythmias during right heart catheterization.
OBJECTIVES
To evaluate if pretreatment with atenolol reduces frequency of ventricular arrhythmias, anesthetist interventions, or shortens procedure time.
ANIMALS
Thirty dogs with pulmonic stenosis scheduled for interventional procedures.
METHODS
Single center, prospective, randomized, open-label study. Dogs were randomized to treatment with atenolol or no treatment preoperatively for a minimum of 10 days. Variables recorded included heart rate, arrhythmias and complexity, total procedure time and administration of antiarrhythmic treatment, vasopressors, positive chronotropes, or fluid boluses.
RESULTS
Fifteen dogs were enrolled in each group. Dogs receiving atenolol had lower mean heart rates during the procedure (atenolol 100 ± 11 bpm vs untreated 115 ± 19 bpm, P = .01). There were no significant differences between the atenolol and untreated groups in the frequency of ventricular ectopic complexes (535 [6-5296] vs 553 [79-2863], P = .9), ventricular couplets (46 [0-481] vs 29 [3-121], P = .59), ventricular triplets (20 [0-265] vs 16 [1-82], P = .67), ventricular tachycardia (8 [0-224] vs 8 [1-118], P = .99), proportion exhibiting R-on-T phenomenon (11/15 vs 14/15, P = .33), proportion receiving intraoperative lidocaine (1/15 vs 3/15, P = .6), vasopressors/positive chronotropes (11/15 vs 5/15, P = .06), or fluid boluses (12/15 vs 7/15, P = .13). The procedure time was similar (atenolol 41 [23-68] min vs untreated 35 [18-98] min, P = .91).
CONCLUSIONS AND CLINICAL IMPORTANCE
No benefit of preoperative atenolol treatment was identified in this small group of dogs.
Topics: Animals; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Atenolol; Dog Diseases; Dogs; Prospective Studies; Pulmonary Valve Stenosis
PubMed: 35302255
DOI: 10.1111/jvim.16403