%0 Journal Article
%T Does atenolol differ from other 汕-adrenergic blockers?
%A Ivar Aursnes
%A Jan-Bjˋrn Osnes
%A Ingunn Tvete
%A Jˋrund Gˋsemyr
%A Bent Natvig
%J BMC Pharmacology and Toxicology
%D 2007
%I BioMed Central
%R 10.1186/1472-6904-7-4
%X We performed an additional analysis with a Bayesian statistical method in order to make further use of the published data.Our calculations on the clinical data in the meta-analysis showed 13% lower risk (risk ratio 0.87) of myocardial infarction among hypertensive patients taking non-atenolol 汕-adrenergic blockers than among hypertensive patients taking atenolol. The 90 % credibility interval ranged from 0.75 to 0.99, thereby indicating statistical significance. The probability of at least 10% lower risk (risk ratio ≒ 0.90), which could be considered to be of clinical interest, was 0.69.Taken together with the other observations of differences in effects, we conclude that the claim that all 汕-adrenergic blockers are inferior drugs for hypertensive patients should be rejected. Atenolol is not representative of the 汕-adrenergic blocker class of drugs as a whole and is thus not a suitable drug for comparisons with other antihypertensive drugs in terms of effect. The non-atenolol 汕-adrenergic blockers should thus continue to be fundamental in antihypertensive drug treatments.In a recent meta-analysis, Lindholm, Carlberg and Samuelsson claim that, in patients with hypertension, the 汕-adrenergic blocker atenolol is no different from other 汕-adrenergic blockers in terms of effects on hard endpoints [1]. This assertion brings to mind the HAPPHY trial [2] in which patients on atenolol showed higher death rates and patients on metoprolol lower death rates than did patients taking diuretics. The difference between the two outcomes was not statistically significant. For other endpoints, only pooled results were released from that study.Atenolol is water-soluble and is therefore distributed to the brain to a much lower extent than most other 汕-adrenergic blockers, which are lipid-soluble. It has been hypothesized that central nervous stimulation of the vagal tone by 汕-adrenergic blockers counteracts a liability towards ventricular fibrillation. In this connection, water-soluble
%U http://www.biomedcentral.com/1472-6904/7/4