-
British Journal of Clinical Pharmacology Dec 19931 We have utilised a non-imaging echo-Doppler cardiac output device, using the principle of attenuated compensation volume flow (ACVF), to assess the cardiovascular... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
1 We have utilised a non-imaging echo-Doppler cardiac output device, using the principle of attenuated compensation volume flow (ACVF), to assess the cardiovascular effects of amlodipine and atenolol over 3 months in 24 patients with essential hypertension. 2 Both amlodipine and atenolol, at 4 and 12 weeks, similarly reduced mean arterial pressure (12 weeks amlodipine -12.6 mmHg, atenolol -14.9 mmHg; P < 0.01 for each vs baseline). 3 The heart rate fell on atenolol, both at 4 weeks (amlodipine -3 vs atenolol -12 beats min(-1); P < 0.05) and 12 weeks (-1 vs -11 beats min(-1); P < 0.05), without change on amlodipine. 4 Stroke volume initially rose on atenolol without change on amlodipine (4 weeks amlodipine -1.3 ml vs atenolol +10.1 ml; P = 0.05) but between drug effects were not different at 12 weeks. 5 The systemic vascular resistance was reduced on amlodipine (12 weeks: amlodipine -176 dyn s cm(-5): P < 0.05) without change on atenolol (atenolol -48 dyn s cm(-5): NS). 6 The cardiac stroke work was lowered on amlodipine both at 4 weeks (P < 0.01) and 12 weeks (P < 0.05) and statistically different from the unaltered atenolol values at both time points. 7 Skin nutrient flow or fingertip temperature was not altered by either treatment. 8 These results are consistent with contrasting mechanisms of action--vasodilator for amlodipine and decreased cardiac pumping for atenolol. The greater reduction in cardiac stroke work on amlodipine compared with atenolol warrants further investigation during longer-term studies.
Topics: Amlodipine; Antihypertensive Agents; Atenolol; Blood Pressure; Double-Blind Method; Heart Rate; Hemodynamics; Humans; Hypertension; Middle Aged; Stroke Volume; Ultrasonography, Doppler; Vascular Resistance
PubMed: 12959272
DOI: 10.1111/j.1365-2125.1993.tb00414.x -
British Medical Journal (Clinical... Feb 1988A randomised double blind parallel group study was performed to compare the efficacy and acceptability of slow release nifedipine (maximum dose 40 mg twice a day) with... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
Nifedipine and atenolol singly and combined for treatment of essential hypertension: comparative multicentre study in general practice in the United Kingdom. Nifedipine-Atenolol Study Review Committee.
A randomised double blind parallel group study was performed to compare the efficacy and acceptability of slow release nifedipine (maximum dose 40 mg twice a day) with those of atenolol (maximum dose 100 mg once a day) as single agents for the treatment of essential hypertension. Of 410 patients recruited almost exclusively from general practices in 22 centres in the United Kingdom 210 received nifedipine and 200 atenolol. Both drugs significantly reduced blood pressure, and control--a reduction of the diastolic pressure to less than 95 mm Hg--was obtained in about 65% of patients. Those who received nifedipine had more pronounced reductions in systolic pressure than those who received atenolol. One hundred and forty nine patients who failed to respond adequately to either atenolol or nifedipine in low doses were given both drugs once daily for eight weeks in a fixed combination capsule that contained atenolol 50 mg and nifedipine 20 mg. All patients showed further reductions in blood pressure, although those who were taking beta atenolol before the combination capsule had more pronounced reductions in systolic pressures. Twenty six patients (12%) were withdrawn because of adverse effects while taking nifedipine compared with 19 (10%) taking atenolol. Flushing and oedema were more common after the calcium antagonist, whereas diarrhoea and dyspepsia were more common after atenolol. The frequencies of headaches, dizziness, fatigue, and dyspnoea were equally distributed between the two groups. When the fixed combination capsule was taken side effects such as flushing and oedema continued. Nifedipine was more effective than atenolol in lowering systolic blood pressure, although neither drug used alone controlled the pressure of more than two thirds of the patients studied. When used in a fixed combination slightly better control of blood pressure was achieved with a lower dose of each drug.
Topics: Adolescent; Adult; Aged; Atenolol; Delayed-Action Preparations; Double-Blind Method; Drug Therapy, Combination; Female; Heart Rate; Humans; Hypertension; Male; Middle Aged; Nifedipine; Random Allocation
PubMed: 2894883
DOI: No ID Found -
Journal of Clinical Pharmacology Nov 2010The objectives were to evaluate the time course for atenolol pharmacokinetics in lactating women postpartum and to quantify atenolol plasma concentrations in the women's...
The objectives were to evaluate the time course for atenolol pharmacokinetics in lactating women postpartum and to quantify atenolol plasma concentrations in the women's 3- to 4-month-old nursing infants. Data were collected during 1 dosing interval from lactating women treated with atenolol for therapeutic reasons, at 2 to 4 weeks (n = 32), 3 to 4 months (n = 22), and 6 to 8 months (n = 17) postpartum. A single blood sample was collected from 15 nursing infants (3-4 months of age) of the mothers participating in the study. At 2 to 4 weeks, 3 to 4 months, and 6 to 8 months postpartum, atenolol infant doses, relative to the mother's weight-adjusted dose, were 14.6% ± 7.6%, 8.3% ± 5.2% and 5.9% ± 2.9%, respectively. Over this time, maternal atenolol pharmacokinetics did not change to a clinically significant extent. Atenolol concentrations were below assay quantification limits (<10 ng/mL) in the plasma of all 3- to 4-month-old nursing infants studied. These findings support the careful use of atenolol during breastfeeding, because in the vast majority of healthy, term infants, atenolol concentrations will be too low to be clinically relevant. Premature infants and those with kidney disease require further study. Infant exposure depends on maternal dose and decreases during the first 6 to 8 months postpartum.
Topics: Adult; Antihypertensive Agents; Atenolol; Dose-Response Relationship, Drug; Female; Follow-Up Studies; Humans; Infant; Lactation; Male; Milk, Human; Postpartum Period; Pregnancy; Time Factors
PubMed: 20145263
DOI: 10.1177/0091270009358708 -
British Journal of Clinical Pharmacology Jun 19791. The pharmacokinetics of intravenous and oral atenolol (50 mg) in six healthy volunteers was studied. Plasma, saliva and urine were collected up to 24 h after each...
1. The pharmacokinetics of intravenous and oral atenolol (50 mg) in six healthy volunteers was studied. Plasma, saliva and urine were collected up to 24 h after each dose. 2. There was no significant difference in atenolol half-life when administered by the two routes. Bioavailability of the orally administered atenolol was 50%. 3. Atenolol levels in saliva required about 2 h to reach equilibrium with plasma drug levels. 4. A comparison between the pharmacokinetics and pharmacology of atenolol was made in twelve healthy subjects. 5. Dose-independent pharmacokinetics were observed. Reductions in resting heart rate and arterial blood pressure were proportional to either the logarithm of dose or area under the plasma concentration time curve or cumulative urinary atenolol excretion. 6. Plasma elimination half-life in five subjects with renal failure was prolonged.
Topics: Administration, Oral; Adult; Atenolol; Creatinine; Female; Half-Life; Humans; Injections, Intravenous; Kidney Diseases; Kinetics; Male; Middle Aged; Propanolamines
PubMed: 465278
DOI: 10.1111/j.1365-2125.1979.tb04644.x -
American Journal of Physiology. Heart... Feb 2003The respective contributions of heart rate (HR) reduction and left ventricular (LV) negative inotropy to the effects of antianginal drugs are debated. Accordingly, eight...
The respective contributions of heart rate (HR) reduction and left ventricular (LV) negative inotropy to the effects of antianginal drugs are debated. Accordingly, eight instrumented dogs were investigated during exercise at spontaneous and paced HR (250 beats/min) after administration of either saline, atenolol, or ivabradine (selective pacemaker current channel blocker). During exercise, atenolol and ivabradine (both 1 mg/kg iv) similarly reduced HR (-30% from 222 +/- 5 beats/min), and LV mean ejection wall stress was not altered. LV dP/dt(max) was reduced by atenolol but not ivabradine. Diastolic time (DT) was increased by atenolol versus saline (195 +/- 6 vs. 123 +/- 4 ms, respectively) and to a greater extent by ivabradine (233 +/- 11 ms). Myocardial oxygen consumption (MVo(2)) was lower under ivabradine and atenolol versus saline (6.7 +/- 0.6 and 4.7 +/- 0.4 vs. 8.1 +/- 0.6 ml/min, respectively, P < 0.05). Under pacing, DT and MVo(2) were similar between ivabradine and saline but significantly reduced with atenolol. Thus HR reduction and negative inotropy equally contribute to the reduction in MVo(2) during exercise in the normal heart. The negative inotropy limits the increase in DT afforded by HR reduction.
Topics: Animals; Anti-Arrhythmia Agents; Atenolol; Benzazepines; Cardiac Pacing, Artificial; Dogs; Heart Rate; Hemodynamics; Ivabradine; Motor Activity; Myocardial Contraction; Myocardium; Oxygen Consumption; Stroke Volume; Ventricular Function, Left
PubMed: 12399255
DOI: 10.1152/ajpheart.00564.2002 -
British Journal of Clinical Pharmacology Nov 2010This study was conducted to determine whether atenolol was able to decrease BP level and mitigate BP increase during dynamic resistance exercise performed at three...
AIMS
This study was conducted to determine whether atenolol was able to decrease BP level and mitigate BP increase during dynamic resistance exercise performed at three different intensities in hypertensives.
METHODS
Ten essential hypertensives (systolic/diastolic BP between 140/90 and 160/105mmHg) were blindly studied after 6 weeks of placebo and atenolol. In each phase, volunteers executed, in a random order, three protocols of knee-extension exercises to fatigue: (i) one set at 100% of 1RM; (ii) three sets at 80% of 1RM; and (iii) three sets at 40% of 1RM. Intra-arterial radial blood pressure was measured throughout the protocols.
RESULTS
Atenolol decreased systolic BP maximum values achieved during the three exercise protocols (100% = 186 ± 4 vs. 215 ± 7, 80% = 224 ± 7 vs. 247 ± 9 and 40% = 223 ± 7 vs. 252 ± 16mmHg, P < 0.05). Atenolol also mitigated an increase in systolic BP in the first set of exercises (100% =+38 ± 5 vs.+54 ± 9; 80% =+68 ± 11 vs. +84 ± 13 and 40% =+69 ± 7 vs.+84 ± 14, mmHg, P < 0.05). Atenolol decreased diastolic BP values and mitigated its increase during exercise performed at 100% of 1RM (126 ± 6 vs. 145 ± 6 and +41 ± 6 vs.+52 ± 6, mmHg, P < 0.05), but not at the other exercise intensities.
CONCLUSIONS
Atenolol was effective in both reducing systolic BP maximum values and mitigating BP increase during resistance exercise performed at different intensities in hypertensive subjects.
Topics: Adult; Antihypertensive Agents; Atenolol; Blood Pressure; Exercise; Female; Humans; Hypertension; Male; Middle Aged; Resistance Training
PubMed: 21039760
DOI: 10.1111/j.1365-2125.2010.03742.x -
British Journal of Clinical Pharmacology Jul 19921. We have studied the effects of a non-absorbable osmotic load on the absorption of a multicomponent solution of frusemide, atenolol, hydrochlorothiazide and salicylic...
1. We have studied the effects of a non-absorbable osmotic load on the absorption of a multicomponent solution of frusemide, atenolol, hydrochlorothiazide and salicylic acid in six healthy volunteers. 2. Each subject was studied on up to four separate occasions. The drugs were administered in one of four solutions: a) a mannitol/electrolyte solution, b) a double-strength mannitol/electrolyte solution, c) a glucose/electrolyte solution and d) water. Lactulose or sulphasalazine were added as oro-caecal transit markers. Lactulose was included in the mannitol- and glucose-based solutions, adding a further non-absorbable osmotic load, and sulphasalazine was added to the water, adding little osmotic load. 3. The absorption of atenolol and hydrochlorothiazide was two- to three-times less from all lactulose-containing solutions than from the sulphasalazine-containing solution. The absorption of frusemide and salicylic acid was similar from all four solutions. 4. The largest non-absorbable osmotic load impaired the absorption of atenolol and hydrochlorothiazide most and the incorporation of glucose only partly restored absorption. 5. These results suggest that transmucosal water movement is an important determinant of atenolol and hydrochlorothiazide absorption but is less relevant for the absorption of frusemide and salicylic acid. Furthermore, these data demonstrate a previously unrecognised interaction between a commonly prescribed laxative--lactulose, and atenolol and hydrochlorothiazide.
Topics: Adult; Atenolol; Furosemide; Gastrointestinal Transit; Humans; Hydrochlorothiazide; Intestinal Absorption; Mannitol; Osmosis; Salicylates; Salicylic Acid
PubMed: 1633066
DOI: 10.1111/j.1365-2125.1992.tb04105.x -
Cardiology 2009beta-Blockers are standard therapy for patients with heart failure (HF). This study compared the effects of chronic monotherapy with 2 different beta(1)-selective... (Comparative Study)
Comparative Study
OBJECTIVES
beta-Blockers are standard therapy for patients with heart failure (HF). This study compared the effects of chronic monotherapy with 2 different beta(1)-selective adrenoceptor blockers, namely atenolol and metoprolol succinate, on left ventricular (LV) function and remodeling in dogs with coronary microembolization-induced HF [LV ejection fraction (EF) 30-40%].
METHODS
Twenty HF dogs were randomized to 3 months of therapy with atenolol (50 mg once daily, n = 6), metoprolol succinate (100 mg, once daily, n = 7) or to no therapy (control, n = 7). LV EF and volumes were measured before initiating therapy and after 3 months of therapy. The change (Delta) in EF and volumes between measurements before and after therapy was calculated and compared among study groups.
RESULTS
In controls, EF decreased and end-systolic volume increased. Atenolol prevented the decrease in EF and the increase in ESV. In contrast, metoprolol succinate significantly increased EF and decreased end-systolic volume. DeltaEF was significantly higher and Deltaend-systolic volume significantly lower in metoprolol succinate-treated dogs compared to atenolol-treated dogs (EF: 6.0 +/- 0.86% vs. 0.8 +/- 0.85%, p < 0.05; end-systolic volume: -4.3 +/- 0.81 ml vs. -1 +/- 0.52 ml, p <0.05).
CONCLUSIONS
In HF dogs, chronic therapy with atenolol does not elicit the same LV function and remodeling benefits as those achieved with metoprolol succinate.
Topics: Adrenergic beta-Antagonists; Animals; Atenolol; Disease Models, Animal; Dogs; Drug Therapy, Combination; Heart Failure; Metoprolol; Random Allocation; Treatment Outcome; Ventricular Function, Left; Ventricular Remodeling
PubMed: 18832825
DOI: 10.1159/000159123 -
Dermatology Online Journal Dec 2020Currently, propranolol, is the first line treatment for problematic infantile hemangioma (IH) management. However, serious side effects have been reported. For that... (Observational Study)
Observational Study
Currently, propranolol, is the first line treatment for problematic infantile hemangioma (IH) management. However, serious side effects have been reported. For that reason, atenolol, a hydrophilic selective beta-1 blocker with the potential for fewer side effects, has been explored. A descriptive, observational case series study of 30 patients between the ages one to 5 months with superficial, deep, or mixed IH was conducted between January 2016 and December 2017. Oral atenolol was administered using a single once daily dose of 1mg/kg, which was adjusted for weight gain each month. The IH was assessed using the Hemangioma Activity Score (HAS) at initiation of treatment, four months, and 9 months of age and improvement percentage was calculated at four and nine months of age. A total of 25 patients completed three evaluations. The baseline, four-month, and 9-month HAS were 4.6, 2.39, and 0.65, respectively. Mean improvement percentage at four months of age was 46.76% and at 9 months of age was 85.65%. No side effects were reported. This study suggests atenolol as an effective treatment for IH in almost all cases, especially in patients who initiated treatment before three months of age. It was well tolerated in all our cases.
Topics: Administration, Oral; Adrenergic beta-1 Receptor Antagonists; Atenolol; Female; Hemangioma; Humans; Infant; Male; Treatment Outcome
PubMed: 33423413
DOI: No ID Found -
British Journal of Clinical Pharmacology Jan 19941. The aim of this randomised, double-blind four way crossover study was to assess the interaction between the new calcium antagonist, lacidipine and atenolol, in... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
1. The aim of this randomised, double-blind four way crossover study was to assess the interaction between the new calcium antagonist, lacidipine and atenolol, in patients with mild to moderate hypertension. 2. Sitting blood pressure at 4 h post-dosing with lacidipine (4 mg) and atenolol (100 mg) alone was significantly lower compared with placebo (137/89 +/- 3/3 mmHg; 142/89 +/- 5/3 mmHg; and 154/98 +/- 5/3 mmHg respectively; P < 0.001). Co-administration of both drugs produced a significant additive effect compared with atenolol and lacidipine alone (124/80 +/- 4/2 mmHg; P < 0.002). 3. Heart rate on treatment with lacidipine alone was significantly greater at 4 h compared with placebo (86 +/- 1 beats min-1 and 74 +/- 2 beats min-1 respectively; P < 0.001). When both drugs were used in combination, there was a significant decrease in pulse rate compared with lacidipine alone (58 +/- 1 beats min-1 and 86 +/- 1 beats min-1 respectively; P < 0.001). 4. Home blood pressure recordings confirmed the statistically significant reduction in blood pressure on co-dosing (120/82 +/- 10/2 mmHg) compared with lacidipine (140/92 +/- 5/3 mmHg) and atenolol (146/90 +/- 6/3 mmHg) given alone (P < 0.05). 5. Lacidipine alone produced a significant exercise tachycardia compared with atenolol alone and the atenolol/lacidipine combination (97 +/- 8 beats min-1; 65 +/- 4 beats min-1 and 75 +/- 7 beats min-1 respectively; P < 0.001). Exercise tolerance was not adversely affected by the co-administration of both lacidipine and atenolol.
Topics: Adult; Antihypertensive Agents; Atenolol; Blood Pressure; Dihydropyridines; Double-Blind Method; Drug Interactions; Drug Synergism; Drug Therapy, Combination; Exercise; Female; Heart Rate; Humans; Hypertension; Male; Middle Aged; Pulse
PubMed: 8148217
DOI: 10.1111/j.1365-2125.1994.tb04237.x