Can
you learn anything new about a commonly prescribed drug
that's been on the market for over three decades? Can
a drug be good at lowering blood pressure without reducing
heart attacks, stroke or cardiovascular deaths? Can a
drug that is prescribed to prevent strokes cause
strokes? The answer is yes to all three questions where
it concerns atenolol, according to a review published
in the British journal, The Lancet (11/6/04). Ironically,
atenolol has long been the first choice drug prescribed
to people with hypertension.
Lately
we have been hearing about old drugs that are better than
newer drugs—diuretics, for example. But here's a story
of an old drug that's worse than some of its newer competitors.
In an added twist, researchers had such confidence in
atenolol that it had become the standard, against which
newer drugs are compared in clinical trials.
33
Years in Use
The
late-breaking news about the downside of atenolol, which
is sold generically and under brand names, such as Tenoretic
and Apo-Atenolol, came from a new review by a Swedish
team of researchers. Over the years, according to the
researchers, there had been questions raised about the
wisdom of using atenolol as the comparator drug in clinical
trials.
The
Swedish researchers led by Bo Carlberg , MD, conducted
a systematic review of all studies that looked specifically
at atenolol's effect on heart-related death and complications
in people with high blood pressure. They identified four
trials that compared atenolol with a placebo (fake pill)
or no treatment. And there were five more trials that
compared atenolol with other antihypertensive drugs. Over
24,000 people, aged 60-74 years, participated in the nine
trials that made up this review; they were followed for
four to six years.
Here
are the combined results of these trials:
