MedWorm: Atenolol

  Effects of Atenolol or Losartan on Fibrinolysis and von Willebrand Factor in Hypertensive Patients With Left Ventricular Hypertrophy

Conclusion: Losartan treatment was associated with preserved fibrinolytic balance compared to a more prothrombotic fibrinolytic and hemostatic state in the atenolol group. These findings suggest different fibrinolytic and hemostatic responses to treatment in hypertensive patients with LVH. (Source: Clinical and Applied Thrombosis/Hemostasis)

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  Journal Scan: Effects of β blockers and Calcium-Channel Blockers on Within-Individual Variability in Blood Pressure and Risk of Stroke (Lancet Neurol 2010;Mar 12:[Epub ahead of print].)

The Anglo-Scandinavian Cardiac Outcomes Trial Blood Pressure Lowering Arm (ASCOT-BPLA) compared amlodipine-based regimens with atenolol-based regimens in 19,257 patients with hypertension and other vascular risk factors, and the Medical Research Council (MRC) trial compared atenolol-based and diuret. . . (Source: Cardiosource)

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  Chronic Heart Rate Reduction Facilitates Cardiomyocyte Survival After Myocardial Infarction.

In this study, we tested the hypothesis that cell survival within the infarct region was enhanced by these two pharmacological agents. Four weeks after ligating the left anterior descending coronary artery, the percentage of the LV that contained the infarct was similar in the untreated (MI) rats and those chronically treated with ivabradine (MI + IVA) or atenolol (MI + ATEN). However, the mean thickness (mm) of the ventricular wall containing the scar was significantly greater in the MI + IVA, 1.54 (P </= 0.01) and the MI + ATEN 1.32, compared to 1.1 in the MI group, due to a 2-fold greater area of surviving cardiomyocytes (P </= 0.01) in the treated rats compared to the untreated group. Regions of cell survival were usually in the subepicardium, with cardiomyocytes surrounding vein...

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  Anti-Hypertensive Drugs To Enhance Esophageal Contraction

Nifedipine, a calcium-channel blocker, was shown to decrease lower esophageal sphincter pressure and increase esophageal acid exposure time, while atenolol, a b1 blocker, was shown to inhibit relaxation of the smooth muscle of the esophagus. However, the influence of these anti-hypertensive drugs on the segment of esophageal body contraction using high-resolution manometry was not fully investigated. A research team from Japan observed esophageal body contraction using high-resolution manometry with 36 intraruminal transducers... (Source: Health News from Medical News Today)

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  Anti-Hypertensive Drugs To Enhance Esophageal Contraction

Nifedipine, a calcium-channel blocker, was shown to decrease lower esophageal sphincter pressure and increase esophageal acid exposure time, while atenolol, a b1 blocker, was shown to inhibit relaxation of the smooth muscle of the esophagus... (Source: GastroIntestinal News From Medical News Today)

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  The quantal secretion of catecholamines is impaired by the accumulation of β-adrenoceptor antagonists into chromaffin cell vesicles

Conclusions and implications: We propose that [beta]-blockers are progressively concentrated into sympathetic secretory vesicles, and interfere with the storage of catecholamines and are co-released with the natural transmitters, resulting in a decrease in the sympathetic tone. This could explain the delayed onset of the hypotensive effects of [beta]-blockers. (Source: British Journal of Pharmacology)

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  Anti-hypertensive drugs to enhance esophageal contraction

(World Journal of Gastroenterology) A research team from Japan clarified the effects of three different types of anti-hypertensive drugs on the three different segments of esophageal body contractions using a recently developed high-resolution manometric system. Their study showed that among the anti-hypertensive drugs tested, atenolol enhanced esophageal motor activity, which was in contrast to nifedipine. (Source: EurekAlert! - Medicine and Health)

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  Nebivolol Dilates Human Penile Arteries and Reverses Erectile Dysfunction in Diabetic Rats through Enhancement of Nitric Oxide Signaling

Conclusions. Nebivolol in vivo activated the NO/cGMP pathway, enhanced erectile response and reversed ED in diabetic rats. Moreover, nebivolol in vitro potentiated NO/cGMP-mediated relaxation of human erectile tissues. These effects may account for the low incidence of ED in nebivolol-treated hypertensive patients. Nebivolol therefore may have utility in the treatment of ED, particularly ED associated with diabetes. Angulo J, Wright HM, Cuevas P, González-Corrochano R, Fernández A, Cuevas B, La Fuente JM, Gupta S, and de Tejada IS. Nebivolol dilates human penile arteries and reverses erectile dysfunction in diabetic rats through enhancement of nitric oxide signaling. J Sex Med **;**:**[ndash]**. (Source: The Journal of Sexual Medicine)

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  Effects of anti-hypertensive drugs on esophageal body contraction.

CONCLUSION: Among the anti-hypertensive drugs tested, atenolol enhanced esophageal motor activity, which was in contrast to nifedipine. PMID: 20180238 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)

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  Elevated Heart Rate in Hypertension: A Target for Treatment?

Poulter et al. () recently reported some interesting data from the ASCOT-BPLA (Anglo-Scandinavian Cardiac Outcomes Trial–Blood Pressure Lowering Arm) study showing that heart rate (HR) reduction with atenolol was not beneficial in patients with fast HR. When subjects were divided into 5 categories of baseline HR, there was no attenuation of the superior impact of allocation to amlodipine-based compared with atenolol-based therapy on event rates among the patients with higher baseline HRs. The authors are to be commended for their interesting analysis, but their interpretation of results does not seem to be appropriate. In the ASCOT-BPLA study, baseline HR was not predictive of outcome, and there was not even a tendency for higher HRs to be associated with increased rate of cardiovascular...

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  Reply

Dr. Palatini misquotes our findings in his first sentence in that we do not mention the effects of heart rate (HR) reduction in our article (). However, he then correctly describes our findings by pointing out that baseline HR did not affect the superiority of amlodipine-based versus atenolol-based therapy in the ASCOT-BPLA (Anglo-Scandinavian Cardiac Outcomes Trial–Blood Pressure Lowering Arm). He further misrepresents our findings when he says that in the ASCOT-BPLA “baseline HR was not predictive of outcome.” In fact, we reported that it predicted all-cause, noncardiovascular, and cardiovascular (CV) mortality, but not nonfatal CV events. These findings are compatible with our statement that “Baseline HR has been reported as a significant predictor of various CV outcomes in some...

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  [Hallucinations and vivid dreams by use of metoprolol.]

Authors: Ahmed AI, van Mierlo PJ, van Waarde JA, Jansen PA A 71-year-old man had had visual hallucinations and vivid dreams for two years after starting to take metoprolol. When metoprolol was replaced by atenolol the patient's symptoms disappeared within five days. Side-effects of beta-blockers on the central nervous system are relatively uncommon. The mechanisms underlying these side-effects are not fully understood. Lipophilic beta-blockers can cross the blood-brain barrier, whereas hydrophilic beta-blockers cannot. Doctors need to be alerted to the varying side-effects of specific beta-blockers. PMID: 20146183 [PubMed - as supplied by publisher] (Source: Tijdschrift voor Psychiatrie)

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  The effects of adrenalectomy and autonomic blockades on the exercise tachycardia in conscious rats.

In conclusion, it is likely that the tachycardia at the beginning of dynamic exercise is predominantly determined by the cardiac autonomic nerve activity, especially by a prompt increase in CSNA, and that the hormonal mechanism due to adrenal epinephrine contributes to a further increase in HR approximately in 13s from the onset of exercise. PMID: 20153986 [PubMed - as supplied by publisher] (Source: Autonomic Neuroscience)

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  Atenolol Pharmacokinetics and Excretion in Breast Milk During the First 6 to 8 Months Postpartum.

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 ...

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  Potential physiological effects of pharmaceutical compounds in Atlantic salmon (Salmo salar) implied by transcriptomic analysis.

CONCLUSIONS: The continuously growing number of annotations of representative species relevant for environmental quality testing is facilitating pathway analysis processes for not completely annotated organisms. KEGG has shown to be a useful tool for the analysis of induced pathways from data generated by microarray techniques with the selected pharmaceutical contaminants acetaminophen, carbamazepine, and atenolol, but further studies have to be carried out in order to determine if a similar expression pattern in terms of fold change quantity and pathways is observed after long-term exposure. Together with the information obtained in this study, it will then be possible to evaluate the potential risk that the continuous release of these compounds may have on the environment and ecosystem f...

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  ATENOLOL (Atenolol) Tablet ATENOLOL ( Atenolol ) Tablet [Cadila Healthcare Limited]

Updated Date: Feb 2, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  ATENOLOL (Atenolol) Tablet ATENOLOL ( Atenolol ) Tablet [Zydus Pharmaceuticals (USA) Inc.]

Updated Date: Feb 2, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Monitoring the effect of chiral pharmaceuticals on aquatic microorganisms by metabolic fingerprinting.

Authors: Wharfe ES, Winder CL, Jarvis RM, Goodacre R The effect of the chiral pharmaceuticals Atenolol and Propranolol on Pseudomonas putida, Pseudomonas aeruginosa, Micrococcus luteus and Blastomonas natatoria was investigated. The growth dynamics of exposed cultures were monitored using a Bioscreen instrument. In addition, FT-IR spectroscopy with appropriate chemometrics and HPLC were employed in order to investigate the phenotypic changes and possible degradation of the drugs in exposed cultures. In the majority of the bacteria studied a statistically significant difference was not observed in the organism's phenotype when exposed to the different enantiomers, or mixtures thereof. By contrast, the pseudomonads appeared to respond differently to Propranolol, with the two enantiomers ...

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  Switch of blood pressure drug might help with hair loss

I am a 39-year-old nurse who is experiencing drastic hair loss. I started taking atenolol for high blood pressure about four months ago. One month after beginning the med, I started losing hair. (Source: L.A. Times - Health)

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  Compensatory mechanisms to maintain blood pressure in paraplegic rats: Implication of central tachykinin NK-1 and NK-3 receptors?

This study examined the intracerebroventricular (i.c.v.) effects of the selective NK-1 receptor agonist [Sar9, Met(O2)11]SP (65pmol, n=6) and NK-3 receptor agonist senktide (650pmol, n=6) on mean arterial pressure (MAP) and HR before and after complete spinal cord transection at thoracic level 4 (T4). [Sar9, Met(O2)11]SP evoked increases in MAP and HR which were still present 4days after the T4 SCI. Further analysis using the β1-adrenoceptor antagonist atenolol (10mgkg−1) revealed an increased contribution of HR in the MAP increase after SCI. For senktide, 2 and 5weeks after T4 SCI, the rise in MAP induced by senktide was significantly increased in magnitude and was similar to a normal response at 8weeks. These effects were accompanied by a bradycardia, which was still present and ampli...

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  ATENOLOL AND CHLORTHALIDONEtablet [Mylan Pharmaceuticals Inc.]

Updated Date: Jan 21, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  beta-adrenergic blockade attenuates cardiac dysfunction and myofibrillar remodeling in congestive heart failure.

Authors: Machackova J, Sanganalmath SK, Elimban V, Dhalla NS Abstract Although beta-adrenoceptor (beta-AR) blockade is an important mode of therapy for congestive heart failure (CHF), subcellular mechanisms associated with its beneficial effects are not clear. Three wks after inducing myocardial infarction (MI), rats were treated daily with or without 20 and 75 mg/kg atenolol, a selective beta(1)-AR antagonist, or propranolol, a nonselective beta-AR antagonist, for 5 wks. Sham operated rats served as controls. All animals were assessed hemodynamically and echocardiographically and the left ventricle (LV) was processed for the determination of myofibrillar ATPase activity, alpha- and beta-myosin heavy chain (MHC) isoforms and gene expression as well as cardiac troponin I (cTnI) phosphor...

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  Simultaneous determination of atenolol and amiloride in pharmaceutical preparations by capillary zone electrophoresis with capacitively coupled contactless conductivity detection.

Authors: Al Azzam KM, Saad B, Aboul-Enein HY Capillary zone electrophoresis coupled with a capacitively coupled contactless conductivity detector (CE-C(4)D) has been employed for the determination of atenolol and amiloride in pharmaceutical formulations. Acetic acid (150 mm) was used as background electrolyte. The influence of several factors (detector excitation voltage and frequency, buffer concentration, applied voltage, capillary temperature and injection time) was studied. Non-UV-absorbing L-valine was used as internal standard; the analytes were all separated in less than 7 min. The separation was carried out in normal polarity mode at 28 degrees C, 25 kV and using hydrodynamic injection (25 s). The separation was effected in an uncoated fused-silica capillary (75 mum, i.d. x 52 ...

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  ATENOLOL (Atenolol) Tablet [Ranbaxy Pharmaceuticals Inc.]

Updated Date: Jan 13, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Hormone and pharmaceutical regulation of ASP production in 3T3-L1 adipocytes

Several studies have demonstrated increases in acylation stimulating protein (ASP), and precursor protein C3 in obesity, diabetes and dyslipidemia, however the nature of the regulation is unknown. To evaluate chronic hormonal and pharmaceutical mediated changes in ASP and potential mechanisms, 3T3-L1 adipocytes were treated with physiological concentrations of relevant hormones and drugs currently used in treatment of metabolic diseases for 48 h. Medium ASP production and C3 secretion were evaluated in relation to changes in adipocyte lipid metabolism (cellular triglyceride (TG) mass, non-esterified fatty acid (NEFA) release and real-time FA uptake). Chylomicrons increased ASP production (up to 411 ± 133% P < 0.05), while leptin, triiodothyronine, and [beta]-blockers atenolol and proprano...

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  Simultaneous determination of atenolol, chlorthalidone and amiloride in pharmaceutical preparations by capillary zone electrophoresis with ultraviolet detection.

Authors: Al Azzam KM, Saad B, Aboul-Enein HY Capillary zone electrophoresis methods for the simultaneous determination of the beta-blocker drugs, atenolol, chlorthalidone and amiloride, in pharmaceutical formulations have been developed. The influences of several factors (buffer pH, concentration, applied voltage, capillary temperature and injection time) were studied. Using phenobarbital as internal standard, the analytes were all separated in less than 4 min. The separation was carried out in normal polarity mode at 25 degrees C, 25 kV and using hydrodynamic injection (10 s). The separation was effected in an uncoated fused-silica capillary (75 mum i.d. x 52 cm) and a background electrolyte of 25 mm H(3)PO(4) adjusted with 1 m NaOH solution (pH 9.0) and detection at 198 nm. The metho...

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  Atenolol: Bradycardia in an elderly patient, treated with glucagon: case report

(Source: Reactions)

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  Solid state stabilisation of the orally delivered drugs atenolol, glibenclamide, memantine and paracetamol through their complexation with cucurbit[7]uril

Fiona J. McInnes, Nahoum G. Anthony, Alan R. Kennedy, Nial J. Wheate (Paper from Org. Biomol. Chem.) Fiona J. McInnes, Org. Biomol. Chem., 2010, DOI: 10.1039/b918372h To cite this article before page numbers are assigned, use the DOI form of citation above. The content of this RSS Feed (c) The Royal Society of Chemistry (Source: RSC - Organic Biomolecular Chemistry)

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  Evaluation and performance of desorption electrospray ionization using a triple quadrupole mass spectrometer for quantitation of pharmaceuticals in plasma.

Authors: Kennedy JH, Wiseman JM The present work describes the methodology and investigates the performance of desorption electrospray ionization (DESI) combined with a triple quadrupole mass spectrometer for the quantitation of small drug molecules in human plasma. Amoxepine, atenolol, carbamazepine, clozapine, prazosin, propranolol and verapamil were selected as target analytes while terfenadine was selected as the internal standard common to each of the analytes. Protein precipitation of human plasma using acetonitrile was utilized for all samples. Limits of detection were determined for all analytes in plasma and shown to be in the range 0.2-40 ng/mL. Quantitative analysis of amoxepine, prazosin and verapamil was performed over the range 20-7400 ng/mL and shown to be linear in all ...

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  Hemolytic anemia in a patient with hypertrophic obstructive cardiomyopathy.

Authors: Kubo T, Kitaoka H, Terauchi Y, Tamura S, Okawa M, Yamasaki N, Yabe T, Doi YL A 66-year-old woman was referred for further evaluation and treatment of normocytic and normochromic anemia with hemoglobin level of 8.6g/dL. A peripheral blood smear showed fragmented erythrocytes. The patient was then referred to the department of cardiology because of systolic murmur, ECG abnormality, and red cell fragmentation. Transthoracic echocardiography revealed hypertrophic cardiomyopathy with particularly increased interventricular septal thickness of 24mm and a hyperkinetic wall motion, resulting in marked obstruction to left ventricular outflow tract (pressure gradient of 200mmHg). Mitral regurgitation due to systolic anterior motion of the mitral valve leaflets was also seen. The cause o...

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  Cardiovascular autonomic dysfunction in a novel rodent model of polycystic kidney disease

This study aimed to define the relationship between hypertension and autonomic function in a new rodent model of polycystic kidney disease (PKD). Using measures of heart rate and systolic blood pressure variability (HRV, SBPV), and time domain analysis of cardiac and sympathetic baroreflex function, we compared the Lewis PKD model (LPK) to a Lewis control. Systolic BP and SBPV were significantly higher in LPK vs. Lewis (168±7 vs. 131±8mm Hg, P≤0.01, total power: 11±3.1 vs. 1.3±0.3mm Hg/Hz2, P≤0.05). LPK has a higher resting HR (437±17 vs. 330±11 beats per minute [bpm], P≤0.001) associated with reduced HRV (total power [1.7±0.3 vs. 4.6±1.1ms/Hz2, P≤0.01]). Atenolol decreased HR to a greater extent in the LPK (90±10 vs. 20±17bpm, P≤0.001) while subsequent methylatropine a...

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  ATENOLOL AND CHLORTHALIDONEtablet [Mutual Pharmaceutical]

Updated Date: Dec 16, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Restoration of neutrophil immunocompetence after cardiopulmonary bypass by beta-adrenergic blockers

Conclusion: The immunomodulatory effects of epinephrine on neutrophils remained unchanged irrespective of cardiopulmonary bypass and could contribute to the detrimental effects of epinephrine after heart surgery. The preoperative administration of nonselective β-blockers abolished the immunomodulatory effects of epinephrine in vitro and in patients, and it enhanced the immunocompetence of neutrophils in a context of increased catecholamine levels. (Source: Surgery)

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  An Open Pilot Study Assessing the Benefits of Quetiapine for the Prevention of Migraine Refractory to the Combination of Atenolol, Nortriptyline, and Flunarizine

Background. Migraine is a prevalent neurological disorder. Although prevention is the core of treatment for most, some patients are refractory to standard therapies. Accordingly, the aim of this study was to evaluate the use of Quetiapine (QTP) in the preventive treatment of refractory migraine, defined as previous unresponsiveness to the combination of atenolol, nortriptyline, and flunarizine.Methods. Thirty-four consecutive patients (30 women and 4 men) with migraine (ICHD-II), fewer than 15 days of headache per month, and not overusing symptomatic medications were studied. All participants had failed to the combination of atenolol (60 mg/day), nortriptyline (25 mg/day), and flunarizine (3 mg/day). Failure was defined as (Source: Pain Medicine)

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  QRS duration predicts sudden cardiac death in hypertensive patients undergoing intensive medical therapy: the LIFE study

Conclusion In the setting of aggressive antihypertensive therapy, prolonged QRS duration identifies hypertensive patients at higher risk for SCD, even after controlling for left bundle branch block, other known risk factors for SCD, and changes in blood pressure and severity of left ventricular hypertrophy. (Source: European Heart Journal)

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  Amelioration of Cardiac Remodeling in Congestive Heart Failure by beta-Adrenoceptor Blockade is Associated with Depression in Sympathetic Activity.

This study investigated whether improvement in cardiac function and attenuation of cardiac remodeling by some beta-adrenoceptor (beta-AR) antagonists were associated with a depression in sympathetic activity in congestive heart failure (CHF) due to myocardial infarction (MI). Although cardiac dysfunction, hypertrophy and dilatation as well as increased plasma level of catecholamines are known to occur in CHF, the relationship between these parameters is poorly understood. Three weeks after occlusion of the coronary artery, rats were treated daily with 20 and 75 mg/kg of either atenolol or propranolol for 5 weeks. Sham-operated rats served as controls. Both atenolol and propranolol at 20 and 75 mg/kg doses attenuated the MI-induced cardiac hypertrophy, increases in left ventricular (LV) end...

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  Differential Effects of Nebivolol and Atenolol on Carotid Arterial Wave Intensity

Background The hemodynamic effects of the vasodilator β-blocker nebivolol may differ from those of a conventional agent. Wave intensity analysis can describe the energy transported by wavefronts in the arterial system in the direction of wave propagation. A non-invasive ultrasound-based technique [1] was used to compare the effects of nebivolol and atenolol on carotid arterial wave intensity in patients participating in a hypertension treatment study. (Source: Artery Research)

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  Atrial tachycardia with 1:1 atrioventricular conduction precipitated by propafenone

A 58-year-old man presented to the emergency department with sudden onset rapid palpitations and significant presyncope while walking on the flat. The previous day he had undergone DC cardioversion for atrial fibrillation (AF) which had been initially successful. However, 6 h after cardioversion he was aware of intermittently raised but regular heart rates. On arrival at the emergency department (ED) he was well with no haemodynamic compromise. The ECG showed an atrial tachycardia instead of AF. Medications consisted of propafenone 300 mg twice daily, bisoprolol 5 mg at night and warfain. Bisoprolol was increased to 5 mg twice daily and he was discharged with a plan for outpatient ablation. He collapsed in the hospital car park with rapid palpations, chest tightness and vagal symptoms. On ...

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  {beta}-Adrenergic Antagonists in Hypertension: A Review of the Evidence (December).

CONCLUSIONS: Overall, data supporting beta-blockers as preferred therapy in hypertension are inadequate. Although most negative cardiovascular and cerebrovascular outcomes of beta-blockers were associated with atenolol therapy, data supporting other beta-blockers in hypertension are lacking. PMID: 19934392 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

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  Nationwide drug-dispensing data reveal important differences in adherence to drug label recommendations on CYP2D6-dependent drug interactions

CONCLUSIONS Clinically important DDIs that are associated with impaired bioactivation of prodrugs might be more easily neglected in clinical practice compared with DDIs that cause drug accumulation and symptomatic adverse drug reactions. (Source: British Journal of Clinical Pharmacology)

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  Fluvial biofilms: A pertinent tool to assess beta-blockers toxicity.

Authors: Bonnineau C, Guasch H, Proia L, Ricart M, Geiszinger A, Romaní AM, Sabater S Among increasingly used pharmaceutical products, beta-blockers have been commonly reported at low concentrations in rivers and littoral waters of Europe and North America. Little is known about the toxicity of these chemicals in freshwater ecosystems while their presence may lead to chronic pollution. Hence, in this study the acute toxicity of 3 beta-blockers: metoprolol, propranolol and atenolol on fluvial biofilms was assessed by using several biomarkers. Some were indicative of potential alterations in biofilm algae (photosynthetic efficiency), and others in biofilm bacteria (peptidase activity, bacterial mortality). Propranolol was the most toxic beta-blocker, mostly affecting the algal photo...

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  Journal Scan: Baseline Heart Rate, Antihypertensive Treatment, and Prevention of Cardiovascular Outcomes in ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) (J Am Coll Cardiol 2009;54:1154-1161.)

The authors reported data from the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA) study, a randomized trial of atenolol ± bendroflumethiazide (atenolol-based) versus amlodipine ± perindopril (amlodipine-based) regimen for treatment of untreated or undertreated hyp. . . (Source: Cardiosource)

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  Meta-analysis: beta-blocker dose, heart rate reduction, and death in patients with heart failure

Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review concluded that the magnitude of heart rate reduction was statistically significantly associated with the survival benefit of beta-blockers in heart failure, but the dose of beta-blocker was not. The majority of the review process and the synthesis were well conducted. Despite the absence of a validity assessment, the conclusions appear likely to be reliable. [Included studies assessed metoprolol, carvedilol, bisoprolol, bucindolol, nebivolol and atenolol. ] CRD Commentary: The review question was clear and was supported by specific inclusion criteria. The authors searched several relevant databases and included attempts to locate unpublished studies in their strategy. This, together with the lack of languag...

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  The challenge of analyzing beta-blocker drugs in sludge and wastewater.

In this study, different approaches were used to assess and overcome the severe effects of interference from the sample matrix from different types of sludges and wastewater on the analysis of nine beta-blockers and the beta sympathomimetic clenbuterol. The partitioning of the target compounds into sludge was investigated in wastewater treatment plants (WWTPs) in both Canada and Germany to evaluate whether this is an important mechanism for removal from sewage. Due to ion suppression in the electro spray interface, absolute recoveries were for certain compounds even lower than 20%. By using surrogate standards, acceptable relative recoveries of >75% were achieved for WWTP influents and effluents and for sludges. These matrix effects underline the need to use appropriate surrogate standa...

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  Regulation of VASP phosphorylation in cardiac myocytes: differential regulation by cyclic nucleotides and modulation of protein expression in diabetic and hypertrophic heart

Vasodilator-stimulated phosphoprotein (VASP) is a major substrate for cyclic nucleotide-dependent kinases that has been implicated in cardiac pathology, yet many aspects of VASP's molecular regulation in cardiomyocytes are incompletely understood. In these studies, we explored the role of VASP, both in signaling pathways in isolated murine myocytes, as well as in a model of cardiac hypertrophy in VASPnull mice. We found that the β-adrenergic agonist isoproterenol promotes the rapid and reversible phosphorylation of VASP at Ser157 and Ser239. Forskolin and the cAMP analog 8-(4-chlorophenylthio)-cAMP promote a similar pattern of VASP phosphorylation at both sites. The effects of isoproterenol are blocked by atenolol and by compound H-89, an inhibitor of the cAMP-dependent protein kinase...

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  FDA approves Twynsta® (telmisartan plus amlodipine) a new single pill combination that delivers powerful and consistent blood pressure reductions throughout 24 hours

Twynsta® delivers very powerful blood pressure (BP) reductions of up to 40/29 mmHg1 and a 24-hour BP response rate of up to 98%2 for hypertensive patients at risk of cardiovascular (CV) events Twynsta® combines the proven evidence base in CV outcomes of telmisartan and amlodipine3-9in a convenient single pill Twynsta® achieves superior BP reductions compared to amlodipine 10mg and is significantly better tolerated with 71% less peripheral oedema.10160 or DBP >10019 References: 1 Data on file, Boehringer Ingelheim. 2 Littlejohn TW III et al. Telmisartan and amlodipine combination therapy is powerful at lowering 24-hour blood pressure: Findings of an ambulatory blood pressure monitoring substudy in hypertensive patients. Presented at the Annual Meeting of the ...

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  Intracoronary intermedin 1-47 augments cardiac perfusion and function in anesthetized pigs: role of calcitonin receptors and {beta}-adrenoreceptor-mediated nitric oxide release

In conclusion, IMD1–47 primarily augmented coronary blood flow and cardiac function through the involvement of calcitonin-related receptor complexes and β2-adrenoreceptor-mediated NO release. The intracellular signaling involved cAMP-dependent activation of kinases and the opening of K+ channels. (Source: Journal of Applied Physiology)

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  Atenolol/chloroquine/dextropropoxyphene: Cardiotoxicity: 2 case report

(Source: Reactions)

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  Cardiovascular autonomic dysfunction in a novel rodent model of polycystic kidney disease.

This study aimed to define the relationship between hypertension and autonomic function in a new rodent model of polycystic kidney disease (PKD). Using measures of heart rate and systolic blood pressure variability (HRV, SBPV), and time domain analysis of cardiac and sympathetic baroreflex function, we compared the Lewis PKD model (LPK) to a Lewis control. Systolic BP and SBPV were significantly higher in LPK vs. Lewis (168+/-7 vs. 131+/-8mm Hg, P</=0.01, total power: 11+/-3.1 vs. 1.3+/-0.3mm Hg/Hz(2), P</=0.05). LPK has a higher resting HR (437+/-17 vs. 330+/-11 beats per minute [bpm], P</=0.001) associated with reduced HRV (total power [1.7+/-0.3 vs. 4.6+/-1.1ms/Hz(2), P</=0.01]). Atenolol decreased HR to a greater extent in the LPK (90+/-10 vs. 20+/-17bpm, P</=0.001) whil...

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  Intravenous Lipid Emulsion as Antidote (review)

CONCLUSION: Available data, though limited,  suggest that ILE may be beneficial in treating life-threatening cardiotoxicity induced by highly lipophilic drugs.  Physicians managing these cases should follow established guidelines and consult at an early stage with a poison center. (66 references) COMMENT:  This thoughtful review is well worth reading. Although ILE is not yet ready for routine use in the early stages of resuscitation, many toxicologists would recommend it as a last-ditch effort when a lipophilic drug has caused cardiovascular collapse not improved by standard treatment.  The strongest statement to this effect has been by Jeffrey Brent in a recent editorial: “It is fair to say that based on what we know so far, no patient dying of cadiotoxic drug poisoning should d...

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  Gas chromatography-mass spectrometry method for determination of metoprolol in the patients with hypertension.

Authors: Yilmaz B, Arslan S, Akba V A sensitive and efficient method was developed for determination of metoprolol in human plasma by gas chromatography-mass spectrometry (GC-MS). Metoprolol and atenolol (internal standard, IS) were extracted from human plasma with a mixture of ethylacetate and diethylether at basic pH with liquid-liquid extraction. Calibration curves were linear over the concentration range 15-500 ng/ml. Intra- and inter-day precision values for metoprolol in human plasma were less than 6.4, and accuracy (relative error) was better than 8.8%. The analytical recovery of metoprolol from human plasma averaged 91.20%. The limits of detection (LOD) and quantification (LOQ) of metoprolol were 5.0 and 15 ng/ml, respectively. Also the developed and validated GC-MS method was ...

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  Atenolol: Hyperkalaemia: case report

(Source: Reactions)

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  Amlodipine achieves greater reduction in carotid BP than atenolol

The calcium channel blocker amlopidine achieves greater reduction in systolic cartotid blood pressure in patients with hypertension than the beta blocker atenolol, study results show. (Source: MedWire News - Cardiology)

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  Atenolol Hepatotoxicity: Report of a Complicated Case (October).

CONCLUSIONS: Despite the fact that beta-blocker-induced hepatotoxicity is probably extremely rare, it must be suspected and the drug therefore discontinued. PMID: 19776295 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

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  Beta-blocker use challenged as first-line antihypertensive therapy

Study results show that for patients with hypertension uncomplicated by coronary heart disease, amlodipine is superior to atenolol treatment in preventing cardiovascular events and procedures even in patients with high heart rates. (Source: MedWire News - Hypertension)

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  Beta-blocker use challenged as first-line antihypertensive therapy

Study results show that for patients with hypertension uncomplicated by coronary heart disease, amlodipine is superior to atenolol treatment in preventing cardiovascular events and procedures even in patients with high heart rates. (Source: MedWire News - Cardiology)

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  Effect Of Antihypertensive Drug Therapy On Short-Term Heart Rate Variability In Newly Diagnosed Essential Hypertension.

Authors: Pavithran P, Prakash ES, Dutta TK, Madanmohan T SUMMARY 1. Abnormalities of cardiac autonomic regulation are a potential mechanism for morbidity despite blood pressure (BP) lowering in hypertension. Analysis of short-term (5 min) heart rate variability provides a noninvasive probe of autonomic regulation of SA node automaticity. 2. We hypothesized that antihypertensive drug therapy would be associated with an increase in 5 min overall HRV along with a decrease in blood pressure (BP), at 8 weeks follow up in subjects with newly diagnosed, never treated essential hypertension. 3. 150 subjects [84 males; 66 females; aged 48 +/- 10 years (mean +/- SD)] with newly diagnosed essential hypertension were divided to 5 groups of 30 each to receive one of the following antihypertensive d...

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  Baseline Heart Rate, Antihypertensive Treatment, and Prevention of Cardiovascular Outcomes in ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial)

Conclusions: There was no evidence that the superiority of amlodipine-based over atenolol-based therapy for patients with hypertension uncomplicated by coronary heart disease was attenuated with higher baseline heart rate. These data suggest that, in similar hypertensive populations without previous or current coronary artery disease, higher baseline heart rate is not an indication for preferential use of beta-blocker–based therapy. (Source: Journal of the American College of Cardiology)

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  Glucagon treatment for bradycardia and a junctional rhythm caused by excessive beta-blockade

A 68-year-old female with a history of coronary artery disease and hypertension presented with a 3h history of lightheadedness and chest discomfort. She was transported to hospital by the emergency medical service. On her arrival she was talking and in obvious discomfort. Her heart rate was 36min−1 and her blood pressure was 72/40mm Hg. The initial physical examination was otherwise unremarkable. The patient's husband informed us of her current medications. These included 50mg oral atenolol twice daily. There had been no recent changes in her medications and there was no suggestion that the patient had taken an overdose. (Source: Resuscitation)

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  Therapeutic effect of {beta}-adrenoceptor blockers using a mouse model of dilated cardiomyopathy with a troponin mutation

Conclusion The highly lipophilic β1-selective β-blocker metoprolol, known to prevent ventricular fibrillation via central nervous system-mediated vagal activation, may be especially beneficial to DCM patients showing a family history of frequent sudden cardiac death, such as those with a deletion mutation K210 in the TNNT2 gene. (Source: Cardiovascular Research)

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  Comparison of Office, Ambulatory, and Home Blood Pressure Antihypertensive Response to Atenolol and Hydrochlorthiazide

J Clin Hypertens (Greenwich). Office, home, and ambulatory blood pressure (BP) demonstrate variable associations with outcomes. The authors sought to compare office BP (OBP), home BP (HBP), and ambulatory BP (ABP) for measuring responses to hydrochlorothiazide (HCTZ), atenolol, and their combination. After completing washout, eligible patients were randomized to atenolol 50 mg or HCTZ 12.5 mg daily. Doses were doubled after 3 weeks and the alternate drug was added after 6 weeks if BP was >120/70 mm Hg (chosen to allow maximum opportunity to assess genetic associations with dual BP therapy in the parent study). OBP (in triplicate), HBP (twice daily for 5 days), and 24-hour ABP were measured at baseline, after monotherapy, and after combination therapy. BP responses were compared between OBP...

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  Gingival overgrowth secondary to amlodipine.

Authors: Dubrey SW, Grocott-Mason R A 66-year-old Asian woman attended for optimization of blood pressure control. Prescribed medication included atenolol (50 mg once daily), bendrofluazide (2.5 mg once daily) and amlodipine (5 mg once daily). She complained of gingival overgrowth, occurring several months after starting amlodipine (Figure 1). PMID: 19749649 [PubMed - as supplied by publisher] (Source: British Journal of Hospital Medicine)

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  Use of atenolol in pregnancy

Source: National Teratology Information Service (NTIS) Area: Evidence > Drugs in Pregnancy SUMMARY: Atenolol is a cardioselective (beta1 selective) beta adrenoceptor blocking drug licensed for the treatment of hypertension, angina pectoris, cardiac dysrhythmia, and for early intervention in the acute phase of myocardial infarction. To date, use of atenolol during pregnancy has not been conclusively associated with an increased risk of structural fetal malformations. Some recent studies have suggested a possible increased risk of congenital heart defects associated with antihypertensive therapy including beta adrenoceptor blocking drugs, however it is unclear whether this risk is due to the underlying maternal condition or the medications. Atenolol use in the first and second trimesters of...

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  Regulation of VASP phosphorylation in cardiac myocytes: Differential regulation by cyclic nucleotides and modulation of protein expression in heart.

Authors: Sartoretto JL, Jin BY, Bauer M, Gertler FB, Liao R, Michel T Vasodilator-stimulated phosphoprotein (VASP) is a major substrate for cyclic nucleotide-dependent kinases that has been implicated in cardiac pathology, yet many aspects of VASP's molecular regulation in cardiomyocytes are incompletely understood. In these studies, we explored the role of VASP both in signaling pathways in isolated murine myocytes as well as in a model of cardiac hypertrophy in VASPnull mice. We found that the beta adrenergic agonist isoproterenol promotes the rapid and reversible phosphorylation of VASP at Ser157 and Ser239. Forskolin and the cAMP analog 8-CPT-cAMP promote a similar pattern of VASP phosphorylation at both sites. The effects of isoproterenol are blocked by atenolol and by compound H-...

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  Procaterol Inhibits Lung Fibroblast Migration

Abstract  Fibroblasts are important cells that are involved in modulation of fibrosis after injuries. In some uncontrollable inflammatory processes, excess fibroblasts migrate around the small airway. The pathogenesis of chronic obstructive pulmonary disease is related to fibrosis around the small airways. The aim of the current study was to investigate the effect of procaterol, a second-generation beta (2)-agonist, on migration of human fetal lung fibroblasts (HFL-1) induced by human plasma fibronectin (HFn). Using the blindwell chamber technique, 10−8 M procaterol inhibited migration of HFL-1 (control, 100%; 10−8 M, 73.2 ± 4.9%; n = 6, p < 0.05). The inhibitory effect of procaterol was concentration-dependent. Although a beta 2-receptor inhibit...

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  Production and Secretion of Adiponectin from 3T3-L1 Adipocytes: Comparison of Antihypertensive Drugs.

ConclusionIn this comparative model, telmisartan, and to a lesser extent, losartan, increased production and secretion of adiponectin from 3T3-L1 adipocytes compared to the other antihypertensive drugs.American Journal of Hypertension 2009; doi:10.1038/ajh.2009.171. PMID: 19730415 [PubMed - as supplied by publisher] (Source: American Journal of Hypertension)

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  Survival among patients with left ventricular systolic dysfunction treated with atenolol.

Authors: Kapoor JR, Heidenreich PA Metoprolol succinate, carvedilol, and bisoprolol are approved for use in heart failure. Other beta-blockers have been found to be inferior (metoprolol tartrate) or have not been studied (atenolol). The authors compared all-cause mortality following treatment with either atenolol, carvedilol, or metoprolol tartrate for 974 patients with left ventricular function < or =40%. The unadjusted mortality at 6 months was lower with atenolol (3.2%) and carvedilol (4.2%) when compared with metoprolol tartrate (7.5%, P< or =.039). However, patients with atenolol were older but had less prior heart failure. After adjustment for the propensity to be treated with atenolol, patients actually treated with atenolol had a significantly lower risk of death compared...

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  Frequency and Risk Factors for Posttransplant Diabetes Mellitus in Iranian Renal Transplant Patients

This study was performed to determine the prevalence of and risk factors for PTDM among Iranian renal transplant recipients. In this cross-sectional study, 300 patients were studied in 2007. It included questionnaires with clinical data and blood samples. PTDM was defined as DM without a pretransplant history. The 184 (61.3%) male and 116 (38.7%) female patients of overall mean age of 41.2 ± 13.5 years were 67.4 ± 48.6 months after the procedure. PTDM was observed in 24 patients (8%). The mean interval to develop PTDM was 19.9 ± 31.5 months. The mean age of PTDM patients was significantly higher than non-PTDM patients: 49.4 ± 13.4 vs 40.6 ± 13.4 years (P < .005). The mean serum high-density lipoprotein (HDL) was higher among PTDM compared with non-PTDM patients: 71.4 ± 21 vs 58.6 ± ...

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  Quiz Page September 2009: Long-standing High-Renin Hypertension and Hypokalemia

A 43-year-old white woman was evaluated for uncontrolled hypertension, progressive weakness, and fatigue. High blood pressure (BP) was diagnosed at the age of 28 years during the first trimester of pregnancy. A caesarean section was performed at week 37 for intrauterine growth retardation and preeclampsia. From 1993 through 2007, her BP was poorly controlled, first on atenolol and indapamide therapy, and then on candesartan and nebivolol therapy. Canrenoate was not tolerated because of nausea and abdominal pain. Her course also has been notable for persistent hypokalemia, with potassium values ranging from 2.8 to 3.2 mEq/L (2.8 to 3.2 mmol/L). (Source: American Journal of Kidney Diseases)

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  Impact of Heart Rate on Central Aortic Pressures and Hemodynamics: Analysis From the CAFE (Conduit Artery Function Evaluation) Study: CAFE-Heart Rate

Conclusions: When comparing beta-blocker–based treatments with other BP-lowering strategies, HR reduction with beta-blockers is a major mechanism accounting for less effective central aortic pressure reduction per unit change in brachial pressure. (Source: Journal of the American College of Cardiology)

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  Effect of Nebivolol and Atenolol on Brachial Artery Flow-Mediated Vasodilation in Patients with Coronary Artery Disease

Content Type Journal ArticleCategory ErratumDOI 10.1007/s10557-009-6187-2Authors John P. Lekakis, Athens University Department of Clinical Therapeutics, Alexandra University Hospital Athens GreeceAthanassios Protogerou, Athens University Department of Clinical Therapeutics, Alexandra University Hospital Athens GreeceChristos Papamichael, Athens University Department of Clinical Therapeutics, Alexandra University Hospital Athens GreeceGeorgia Vamvakou, Athens University Department of Clinical Therapeutics, Alexandra University Hospital Athens GreeceIgnatios Ikonomidis, Athens University Department of Clinical Therapeutics, Alexandra University Hospital Athens GreeceFrancesco Fici, 2nd University of Naples Excellent Center for Cardiovascular Disease, Department of Experimental Medicine(P...

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  Pharmacokinetics and safety of olmesartan medoxomil in combination with either amlodipine or atenolol compared to respective monotherapies in healthy subjects

The aim of this study was to investigate any influence on olmesartan plasma pharmacokinetics from amlodipine or atenolol. We analysed pharmacokinetics and safety of olmesartan medoxomil in combination with either amlodipine or atenolol compared to respective monotherapies in two separate studies. In one study, 18 subjects received once daily treatment for 7 days with olmesartan medoxomil 20 mg alone or with amlodipine 5 mg or amlodipine 5 mg alone. In the other study, atenolol 50 mg once daily replaced amlodipine. Concentration vs. time profiles for olmesartan monotherapy were similar to combination therapy. Mean olmesartan AUCss,[tau] for olmesartan alone and with amlodipine were 2439 and 2388 ng h/mL and for olmesartan alone and with atenolol were 2340 and 2247 ng h/mL. Corresponding olm...

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  Head dizzy

Author: HHH Posted: Wed Jul 29, 2009 11:04 pm For the past month ive been fealing really dizzy and with every step i take walking it feals like my brain is rocking against my head. Every time i move my eyes i can hear something like fluid in my right ear. I though it was fluid in my ear and went to doc and got antibiotics but its still there. I was on every pain pill there is for 10 years. Ive been on suboxone for 7 months. Im down to 4mg a day. Im also on 50mg of atenolol for high blood pressure. I know that its not my BP med because i just was put on 25mg more and there was no differance. So i dont know what it is or what to do. (Source: Suboxone Forum)

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  Serial evaluation of electrocardiographic left ventricular hypertrophy for prediction of risk in hypertensive patients

Conclusions: Regression of ECG LVH by Cornell product and/or Sokolow-Lyon voltage criteria during antihypertensive therapy is associated with lower likelihoods of CV morbidity and mortality, all-cause mortality, and new-onset diabetes, independent of blood pressure lowering and treatment modality in essential hypertension. These findings suggest that antihypertensive therapy targeted at regression or prevention of ECG LVH may improve prognosis. (Source: Journal of Electrocardiology)

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  Change in mRNA Expression after Atenolol, a Beta-adrenergic Receptor Antagonist and Association with Pharmacological Response

Conclusion. The expression of several genes not previously identified as part of the adrenergic signaling pathway changed in response to a single oral dose of atenolol. Variation in these genes could contribute to unexplained differences in response to [beta]-blockers. (Source: Archives of Drug Information)

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  Investigation of enantiomeric separation of basic drugs by capillary electrophoresis using clindamycin phosphate as a novel chiral selector

In this study clindamycin phosphate belonging to the group of lincomycin antibiotics is first used as a novel chiral selector for the enantiomeric separations of several racemic basic drugs, which possess high separability, consisting of nefopam, citalopram, tryptophan, chlorphenamine and propranolol. Other basic drugs giving partial enantioseparation include tryptophan methyl ester, metoprolol and atenolol. Clindamycin phosphate possesses advantages such as high solubility and low viscosity in the water and very weak UV absorption. In the course of this work we observed that both migration time and enantioseparation were influenced by several parameters such as pH of the BGE, clindamycin concentration, capillary temperature, applied voltage and organic modifier. The optimum pH that was in...

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  Antihypertensive drugs and central blood pressure

Abstract  Recent evidence suggests that central blood pressure is a more important determinant of cardiovascular risk than brachial pressure. Interestingly, antihypertensive drugs exert different effects on brachial and central pressure. Traditional β-blockers, such as atenolol, appear to have an adverse impact on central pressure, despite lowering brachial pressure. This may help to explain the results of recent large outcome studies using atenolol. Further research is required to clarify whether other antihypertensive agents lower central pressure beyond the effects observed on brachial pressure. Content Type Journal ArticleDOI 10.1007/s11906-009-0043-4Authors Carmel M. McEniery, University of Cambridge, Addenbrooke’s Hospital Clinical Pharmacology Unit Box 110 Camb...

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  “In-house” pharmacological management for computed tomography coronary angiography: heart rate reduction, timing and safety of different drugs used during patient preparation

Abstract  We retrospectively evaluated the effect, timing and safety of different pharmacological strategies during 64-slice CT coronary angiography (CT-CA). From the institutional database of CT-CA we enrolled 560 consecutive patients with suspected coronary artery disease. The type of drug preparation (group 1 = no treatment; group 2 = oral metoprolol; group 3 = other; group 4 = intravenous (IV) atenolol; group 5 = IV atenolol + nitrates; NR = non-responders), timing, and adverse effects were recorded. Heart rate (HR) during different preparation phases was recorded. Four adverse effects were recorded, none of which was attributable to pharmacological treatment. In all groups, except group 1, the HR on arrival was significantly reduced by the pharmacological treat...

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  Effect of Metformin on Weight Gain During Antihypertensive Treatment With a beta-Blocker in Chinese Patients.

ConclusionsCombination therapy of nitrendipine and atenolol may significantly increase BW and fasting BG in overweight or obese patients with hypertension. Metformin may prevent BW gain and improve BG levels in hypertensive patients who received combination therapy of nitrendipine and atenolol.American Journal of Hypertension 2009; doi:10.1038/ajh.2009.93American Journal of Hypertension 2009; doi:10.1038/ajh.2009.93. PMID: 19574961 [PubMed - as supplied by publisher] (Source: American Journal of Hypertension)

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  Hydrochlorothiazide and Atenolol Combination Antihypertensive Therapy: Effects of Drug Initiation Order.

Authors: Johnson JA, Gong Y, Bailey KR, Cooper-Dehoff RM, Chapman AB, Turner ST, Schwartz GL, Campbell K, Schmidt S, Beitelshees AL, Boerwinkle E, Gums JG For combination antihypertensive therapy with thiazide diuretics and beta-blockers, the effect of the order of initiation of the drugs on the outcome has not been tested. Patients with uncomplicated hypertension were randomized to receive either hydrochlorothiazide (HCTZ) or atenolol monotherapy, followed by addition of the alternative drug. Blood pressure (BP) responses were evaluated by race and order of drug initiation. A total of 368 participants received combination therapy. Among the participants, blacks showed a greater BP-lowering effect than whites did with HCTZ monotherapy (-13.0/-7.4 mm Hg vs. -8.0/-4.2 mm Hg, P < 0.001...

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  Combination pharmacotherapy in the treatment of experimental cardiac arrest

Conclusions: The administration of a drug combination of epinephrine + atenolol + levosimendan, when given during CPR, in a pig model of cardiac arrest, results in improved 48-hour survival and improves postresuscitation cardiac function. (Source: The American Journal of Emergency Medicine)

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  Exercise Tolerance After Beta Blockade in Recent Cardiac Transplant Recipients

Conclusions: This study showed little adverse effect on exercise tolerance by beta blockade in recently transplanted patients. Atenolol seemed to be safe in this context. (Source: Transplantation Proceedings)

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  Sertraline-Induced Rhabdomyolysis in an Elderly Patient with Dementia and Comorbidities (July/August).

CONCLUSIONS: This patient's rhabdomyolysis was probably induced by sertraline therapy. PMID: 19567656 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

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  Catecholaminergic automatic activity in the rat pulmonary vein: electrophysiological differences between cardiac muscle in the left atrium and pulmonary vein

Ectopic activity in cardiac muscle within pulmonary veins (PVs) is associated with the onset and the maintenance of atrial fibrillation in humans. The mechanism underlying this ectopic activity is unknown. Here we investigate automatic activity generated by catecholaminergic stimulation in the rat PV. Intracellular microelectrodes were used to record electrical activity in isolated strips of rat PV and left atrium (LA). The resting cardiac muscle membrane potential was lower in PV [–70 ± 1 (SE) mV, n = 8] than in LA (–85 ± 1 mV, n = 8). No spontaneous activity was recorded in PV or LA under basal conditions. Norepinephrine (10–5 M) induced first a hyperpolarization (–8 ± 1 mV in PV, –3 ± 1 mV in LA, n = 8 for both) then a slowly dev...

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  Postmyocardial infarction remodeling and coronary reserve: effects of ivabradine and beta blockade therapy

In conclusion, 1) Iva has advantages over Aten in postinfarction therapy that are not due to differential effects of the drugs on heart rate, and 2) age limits growth factor upregulation, angiogenesis, and arteriogenesis in the postinfarcted heart. (Source: AJP: Heart and Circulatory Physiology)

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  Beta blockers for peripheral arterial disease.

CONCLUSIONS: Currently, there is no evidence to suggest that beta blockers adversely affect walking distance in people with intermittent claudication. Beta blockers should be used with caution if clinically indicated, especially in patients with critical ischaemia where acute lowering of blood pressure is contraindicated. PMID: 19359199 [PubMed - in process] (Source: PubMed: Eur J Vasc Endovasc ...)

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  Combination of amlodipine and enalapril in hypertensive patients with coronary disease

CONCLUSION: The fixed combination of enalapril and amlodipine, as well as isolated amlodipine, was effective in the normalization of BP in pts with CAD and SAH stages I and II, adding blockage of the renin-angiotensin system.FUNDAMENTO: Pacientes (pts) con enfermedad coronaria (EAC) estable pueden beneficiarse con una menor presión arterial (PA), de acuerdo con estudios recientes. OBJETIVO: Evaluar la eficacia y la tolerancia de la combinación fija amlodipino + enalapril, comparada a el amlodipino en la normalización de la PA diastólica (PAD) (< 85 mmHg), en pts con EAC y HAS. MÉTODOS: Estudio doble ciego, randomizado, con dos grupos de pts con PAD >90 y 110 mmHg durante el wash-out de cuatro semanas, en uso sólo de atenolol. Después del wash-out randomizamos para combinación (A) o...

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  Fractal properties of human heart period variability: physiological and methodological implications.

Authors: Tan CO, Cohen MA, Eckberg DL, Taylor JA Fractal frequency scaling of heart period variability is used as a concise index of overall cardiac control. However, no prior study has assessed within-individual reproducibility of fractal indices of heart period, or reported how the estimated indices respond to autonomic blockade. Therefore, we examined fractal properties of the heart period from ten young, healthy individuals during three separate experimental sessions under control (saline) conditions and twice under combined autonomic blockade (atenolol and atropine sulfate) conditions. Under each condition, R-R intervals were recorded with the subject in the supine and the 40 degree upright tilt positions during 20 minutes of controlled breathing in each position. We calculated th...

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  Wide Disparity Found in Drug Prices for Diabetes Patients

July 11, 2009 (Newswise) - New research from Mount Sinai School of Medicine has found that the price in New York and New Jersey of the medications most commonly prescribed for patients with diabetes varies widely depending on where you shop. Researchers found that the combined cost of a 30-day supply of the ten medications most used by diabetics varied from a low of $428.35 at Medco by Mail up to $641.90 at Rite Aid. The study is of out-of-pocket costs for people who do not have prescription drug insurance. Ronald Tamler, MD, PhD, MBA, Assistant Professor of Medicine, Division of Endocrinology and Diabetes, and Clifton Jackness, MD, Department of Internal Medicine, Mount Sinai School of Medicine, compiled a list of the ten medications most often prescribed to patients ages 18 to 65 who...

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  Case Study: A 64-Year-Old Female Presents With Chest Pain of 3 Hours' Duration and an ECG Consistent With Acute Anterior MI

This 64-year-old with a history of hypertension, managed with atenolol 100 mg daily, presented with 3 hours of chest pain and electrocardiographic (ECG) evidence of an acute anterior MI. She underwent immediate percutaneous coronary intervention (PCI) of an occluded left anterior descending artery. . . . (Source: Cardiosource)

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  Pulse pressure and risk of cardiovascular outcomes in patients with hypertension and coronary artery disease: an INternational VErapamil SR-trandolapril STudy (INVEST) analysis

Conclusion In CAD patients with hypertension, PP (on anti-hypertensive treatment) is a weaker predictor of cardiovascular outcomes than SBP, DBP, or MAP. (Source: European Heart Journal)

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  Effect of cardiopulmonary bypass on the pharmacokinetics of propranolol and atenolol.

The objective of this study was to compare the effect of coronary artery bypass graft (CABG) surgery employing CPB on the pharmacokinetics of propranolol and atenolol. We studied patients receiving oral propranolol with doses ranging from 80 to 240 mg (N = 11) or atenolol with doses ranging from 25 to 100 mg (N = 8) in the pre- and postoperative period of CABG with moderately hypothermic CPB (32 degrees C). On the day before and on the first day after surgery, blood samples were collected before beta-blocker administration and every 2 h thereafter. Plasma levels were determined using high-performance liquid chromatography and data were treated by pharmacokinetics-modelling. Statistical analysis was performed using ANOVA or the Friedman test, as appropriate, and P < 0.05 was considered t...

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  Reversed-phase high-performance liquid chromatographic enantioresolution of six beta-blockers using dinitrophenyl-l-Pro-N-hydroxysuccinimide ester, N-succinimidyl-(S)-2-(6-methoxynaphth-2-yl) propionate and twelve variants of Sanger's reagent as chiral derivatizing reagents.

Authors: Bhushan R, Tanwar S Twelve chiral derivatizing reagents (CDRs) were synthesized by substituting one of the fluorine atoms in 1,5-difluoro-2,4-dinitrobenzene (DFDNB) with three optically pure amines [(R)-(-)-1-cyclohexylethylamine, (+)-dehydroabietylamine and (S)-(-)-alpha,4-dimethylbenzylamine], six amino acid amides [l-Ala-NH(2), l-Phe-NH(2), l-Val-NH(2), l-Leu-NH(2), l-Met-NH(2) and d-Phg-NH(2)] and three amino acids [l-Ala, l-Val and l-Leu]. In addition, dinitrophenyl-l-Pro-N-hydroxysuccinimide ester and N-succinimidyl-(S)-2-(6-methoxynaphth-2-yl) propionate were also synthesized and used as CDR. Keeping in view the presence of an amino group, diastereomers of six beta-blockers (atenolol, propranolol, bisoprolol, metoprolol, salbutamol, and carvedilol) were synthesized by r...

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  Different Metabolic Effects of Selective and Nonselective Beta-Blockers Rather Than Mere Heart Rate Reduction May Be the Mechanisms by Which Beta-Blockade Prevents Cardiovascular Events

We read with interest the article by Bangalore et al. (), who analyzed in 9 trials the role of pharmacologic reduction of heart rate (HR) using beta-blockers in preventing cardiovascular events in patients with hypertension. Beta-blocker–induced lower HR was associated with greater mortality and morbidity risk. As the basis of worse outcomes with “beta-blockers,” the authors recognize only an increase in central aortic/pulse pressure with pharmacologic HR lowering. Even though they acknowledge that the beta-blocker used in the studies was mainly atenolol, and hence, any extrapolation of these results to other beta-blockers should be done with caution, the whole paper and the accompanying editorial just generically refer to “beta-blockade.” In fact, the mechanisms by which beta-bl...

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  Beta-Blocker–Induced Heart Rate Reduction: Too Simplistic to Explain the Deleterious Effects of Beta-Blockers

In their recently published article, Bangalore et al. () concluded, from a meta-regression analysis of 9 studies including a total of 34,096 patients taking beta-blockers as first-line therapy and 30,139 patients taking other antihypertensive agents, that beta-blocker–associated reduction in heart rate increased the risk of myocardial infarction, cardiovascular events, and death for hypertensive patients. The authors suggested, as a mechanism, that “pharmacologically induced bradycardia leads to dyssynchrony or uncoupling between outgoing and reflected wave, thereby elevating central aortic pressure.” They referred to the CAFE (Conduit Artery Functional End Point) study, which showed a higher central aortic systolic blood pressure after atenolol-based treatment than after amlodipine-...

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  Beta-Blockers, Hypertension, and Randomized Controlled Trials: Science and Sensibility

Bangalore et al. () suggest that beta-blocker–induced reduction of heart rate increases the risk for cardiovascular events and death for hypertensive patients. Results of meta-analyses should be viewed with circumspection, especially when clinical practice might be influenced (). With one-fifth of the general population susceptible to migraine (and other primary vascular headaches) and with nonvasodilating beta-blockers still regarded as first-line preventive agents, the conclusions of this study () raise concern. The authors admittedly ignore the dose of atenolol (), a critical variable that limits this analysis. Besides, biologically, in no 2 patients can the evolution of atherosclerosis or its complications be strictly comparable. Statistics do permit such mathematical comparisons in ...

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  Atenolol Is Dead: Long Live Beta-Blockade

Bangalore et al. () recently reported that a lower heart rate was associated with a greater risk for all-cause mortality (r = −0.51; p < 0.0001), cardiovascular mortality (r = −0.61; p < 0.0001), myocardial infarction (MI) (r = −0.85; p < 0.0001), stroke (r = −0.20; p = 0.06), or heart failure (r = −0.64; p < 0.0001). They concluded that beta-blocker–associated reduction in heart rate increased the risk of cardiovascular events and death in hypertensive patients, in contrast to patients with MI and heart failure. In an accompanying editorial, Kaplan () stated that beta-blockers will continue to be indicated for heart failure, tachyarrhythmias, and secondary prevention post-MI, but not for treatment of hypertension in patients without these compelling indications. However, as th...

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  Atenolol Versus Other Beta-Adrenergic Blockers

The question is: Does atenolol differ from other beta-adrenergic blockers in clinical outcome? Bangalore et al. () nicely related unfavorable trial outcomes to the degree of pulse rate reduction induced by beta-adrenergic blockers. But is it not a mistake to include the HAPPHY (Heart Attack Primary Prevention in Hypertension) trial without considering that the 2 beta-adrenergic blockers arms differed as to outcome ()? Patients on atenolol showed higher death rates and patients on metoprolol showed lower death rates than did patients taking diuretics. The difference between the 2 outcomes was not by itself statistically significant (results with other end points were neither reported nor provided on request). But together with a borderline significant difference between atenolol and other b...

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  The Effects of Antihypertensive Treatment on the Doppler-Derived Myocardial Performance Index in Patients with Hypertensive Left Ventricular Hypertrophy: Results from the Swedish Irbesartan in Left Ventricular Hypertrophy Investigation Versus Atenolol (SILVHIA)

Conclusion: The MPI exhibited a modest decrease after 48 weeks of antihypertensive treatment in patients with hypertensive left ventricular hypertrophy. Changes in MPI were associated with changes in left ventricular function and vascular compliance, rather than with changes in left ventricular remodeling or blood pressure. (ECHOCARDIOGRAPHY, Volume **, ************) (Source: Echocardiography)

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  Outcomes of Pregnancies at Risk for Hypertensive Complications Managed Using Impedance Cardiography

Amer J PerinatolDOI: 10.1055/s-0029-1223283ABSTRACTWe assessed the effect of antihypertensive therapy guided by impedance cardiography on maternal and fetal outcomes in pregnancies at risk for hypertensive complications. We performed a retrospective review of the outcomes of 318 singleton pregnancies with chronic hypertension or prior preterm delivery due to preeclampsia whose antihypertensive therapy was guided by impedance cardiography. Hemodynamic subsets were compared using analysis of variance. Impedance cardiography was used to evaluate cardiac output and total peripheral resistance starting at less than 24 weeks. All patients received atenolol; 24% required additional therapy with a vasodilator. The mean gestational age at delivery was 37 ± 2 weeks. Preeclampsia develop...

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  Cardiovascular effects of ghrelin antagonist in conscious rats.

Authors: Vlasova MA, Järvinen K, Herzig KH Ghrelin, a 28 aa growth-hormone-releasing peptide, has been shown to increase food intake and decrease arterial pressure in animals and in humans. Recently, a ghrelin antagonist (GhA), [d-Lys-3]-GHRP-6, was demonstrated to decrease food intake in mice, but its cardiovascular actions have not been described. In the present study, the effects of the GhA on cardiovascular parameters in conscious rats were investigated and the involvement of the sympathetic nervous system evaluated. Mean arterial pressure (MAP) and heart rate (HR) measurements were assessed by radiotelemetry. GhA was administered in doses of 2, 4 and 6 mg/kg subcutaneously (s.c.). MAP as well as HR was dose-dependently elevated after sc application of GhA. Sympathetic blockad...

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  Clinical Challenges and Images in GI

Question: A 56-year-old man presented with abdominal pain and melena. His past medical history included immunoglobulin A nephropathy, hypertension, and petit mal epilepsy. He had undergone living-related renal transplantation for end-stage disease 6 months previously, receiving basiliximab and prednisone induction therapy and tacrolimus and azathioprine maintenance treatment. His other medications were atenolol, sodium valproate, and co-trimoxazole. He presented with stable vital signs with a low-grade fever, the abdomen was soft and nontender with melena on rectal examination. His hemoglobin was 9.9 g/dL, blood urea nitrogen 54 mg/dL, and creatinine was stable at 2.7 mg/dL. (Source: Gastroenterology)

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  Circulating adrenaline released by sympathoadrenal activation elicits acute vasodilatation in the rat masseter muscle

Abstract: The present study was designed to examine the effects of circulating catecholamines released by sympathoadrenal system on the haemodynamics of the masseter muscle in deeply urethane-anaesthetized, artificially ventilated, cervically vagotomized and sympathectomized rats. Intravenous administration of adrenaline induced a biphasic change of blood flow in the masseter muscle (MBF). The change of blood flow showed an initial marked increase and successive slight decrease in a dose-dependent manner (0.01–1μg/kg). The administration of noradrenaline had no significant effect on the MBF. The increase in the MBF evoked by exogenously applied adrenaline was markedly reduced by the intravenous administration of propranolol (100μg/kg), whereas pretreatment with either hexamethonium (10...

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  Polycap (thiazide, atenolol, ramipril, simvastatin, aspirin) reduces cardiovascular risk

In this study the authors changed the forumalation by removing folate and examined the effect of the now-called "Polycap" combination on blood pressure, lipids, heart rate, and urinary thromboxane B2, and assessed its tolerability.The double-blind trial in 50 centers in India inlcluded 2053 individuals without cardiovascular disease, aged 45—80 years, and with one cardiovascular risk factor.The Polycap consisted of low daily doses of:- thiazide (12·5 mg)- atenolol (50 mg)- ramipril (5 mg)- simvastatin (20 mg)- aspirin (100 mg)The other 8 treatment groups included:, aspirin alone, simvastatin alone, hydrochlorthiazide alone, three combinations of the two blood-pressure-lowering drugs, three blood-pressure-lowering drugs alone, or three blood-pressure-lowering drugs plus aspirin.Blood Pre...

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  The Lifetime Cost Effectiveness of Amlodipine-Based Therapy Plus Atorvastatin Compared with Atenolol Plus Atorvastatin, Amlodipine-Based Therapy Alone and Atenolol-Based Therapy Alone: Results from ASCOT1

(Source: PharmacoEconomics)

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  Health News of the Day

is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.Polycap (thiazide, atenolol, ramipril, simvastatin, aspirin) reduces multiple risk factors and cardiovascular risk. http://bit.ly/bEyABTiming of initiation of antiretroviral therapy in AIDS-free HIV-1-infected patients: 350 cells/L is minimum threshold http://bit.ly/jlrYLVivaglobin is the first and only FDA-approved Sub-Q Immunoglobulin for Primary Immunodeficiency Disorder (PIDD) http://www.vivaglobin.comJohns Hopkins over-enthusiastic about Twitter: search is great, "extremely useful," "our feed is worth following" http://is.gd/sZuLLinksCNN's Dr. Sanjay Gupta first video blog post: http://...

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  Effect of Antihypertensive Therapy on Serum Lipids in Newly Diagnosed Essential Hypertensive Men

The effect of antihypertensives on serum lipids in newly diagnosed male essential hypertensive patients was studied. The participants (n = 99) were randomly allocated to receive amlodipine, atenolol, enalapril, hydrochlorothiazide, and a combination of amlodipine and atenolol. Lipid parameters were estimated before and after 8 weeks of therapy. The atenolol and thiazide group showed a significant increase in triglycerides (TGs) and very-low-density lipoprotein cholesterol (VLDL-C). High-density lipoprotein cholesterol (HDL-C) and HDL-C to low-density lipoprotein cholesterol (LDL-C) ratio were significantly increased and TC to HDL-C ratio was significantly decreased in the amlodipine and amlodipine— atenolol combination groups. In the enalapril group, we found a significant reduction ...

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  Clustered metabolic abnormalities blunt regression of hypertensive left ventricular hypertrophy: the LIFE study

We examined whether clusters of two or more metabolic abnormalities (MetAb, including obesity, high plasma glucose without diabetes, low HDL-cholesterol) in addition to hypertension were associated to levels of ECG LVH reduction comparable to that obtained in hypertensive subjects without or with only one additional metabolic abnormality (no-MetAb).Methods and results: We studied 5558 non-diabetic participants without MetAb (2920 women) and 1235 with MetAb (751 women) from the LIFE-study cohort. MetAb was defined by reported LIFE criteria, using partition values from the ATPIII recommendations. Time-trends of Cornell voltage–duration product (CP) over 5 years was assessed using a quadratic polynomial contrast, adjusting for age, sex, prevalent cardiovascular disease and treatment arm (lo...

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  Brachial Artery Differential Characteristic Impedance: Contributions from Changes in Young’s Modulus and Diameter

Abstract  This examination of brachial artery (BA) differential characteristic impedance, ΔZ c, illustrates that changes in Z c can occur from changes in either BA wall stiffness (Young’s modulus, E) and/or its diameter, D. Furthermore, we assessed how changes in both E and D combine in either an isolated, synergistic, or antagonistic manner to yield the net change in BA Z c. The basis of this analysis is a partial differential equation which approximates ΔZ c as a total differential. The effects on BA ΔZ c of acetylcholine, atenolol, fenoldapine, nitroglycerin, hydrochlorothiazide and other medications are examined using data from previously published studies. Clinical situations which alter BA Z c, such as congestive heart failure, hypertension, and hyperemia, are a...

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  The Lifetime Cost Effectiveness of Amlodipine-Based Therapy Plus Atorvastatin Compared with Atenolol Plus Atorvastatin, Amlodipine-Based Therapy Alone and Atenolol-Based Therapy Alone: Results from ASCOT 1.

Page: 221DOI: 10.2165/00019053-200927030-00005Authors: Lindgren, Peter 1 2; Buxton, Martin 3; Kahan, Thomas 4; Poulter, Neil R. 5; Dahlof, Bjorn 6; Sever, Peter S. 5; Wedel, Hans 7; Jonsson, Bengt 8; on behalf of the ASCOT investigators (Source: PharmacoEconomics)

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  Beta Blockers for Peripheral Arterial Disease

Conclusions: Currently, there is no evidence to suggest that beta blockers adversely affect walking distance in people with intermittent claudication. Beta blockers should be used with caution if clinically indicated, especially in patients with critical ischaemia where acute lowering of blood pressure is contraindicated. (Source: European Journal of Vascular and Endovascular Surgery)

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  Clustered metabolic abnormalities blunt regression of hypertensive left ventricular hypertrophy: the LIFE study.

CONCLUSIONS: Clusters of metabolic abnormalities resembling phenotypes of metabolic syndrome are related to greater initial ECG LVH in hypertensive patients with value of blood pressure similar to individuals without metabolic abnormalities, and are associated with less reduction of ECG LVH during antihypertensive therapy, potentially contributing to the reported adverse prognosis of metabolic syndrome. PMID: 19361968 [PubMed - as supplied by publisher] (Source: Diabetes Metab)

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  Increased leukotriene concentration× in submandibular glands from rats with experimental periodontitis

Conclusion  In submandibular glands from rats with periodontitis, the increment in mucin release and cysteinyl-leukotrienes production are related events and both are associated with the sympathetic system. Content Type Journal ArticleCategory Original Research PaperDOI 10.1007/s00011-009-0008-8Authors Lucila Busch, University of Buenos Aires Pharmacology Unit, School of Dentistry Buenos Aires ArgentinaValeria Miozza, University of Buenos Aires Pharmacology Unit, School of Dentistry Buenos Aires ArgentinaLeonor Sterin-Borda, University of Buenos Aires Pharmacology Unit, School of Dentistry Buenos Aires ArgentinaEnri Borda, University of Buenos Aires Pharmacology Unit, School of Dentistry Buenos Aires Argentina Journal Inflammation ResearchOnline ISSN 1420-908XPri...

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  Hard-Hearted “HITT” to the Heart (Mural Thrombus from Heparin-Induced Thrombocytopenia with Thrombosis Syndrome)

A 56-year-old woman presented to the Emergency Department with the complaint of right leg pain and dyspnea 11 days post 4-vessel coronary artery bypass graft. She had a history of hypertension, atrial fibrillation, and post-procedure pericarditis and effusion. She had been treated with heparin i.v. for 7 days at the hospital where surgery was performed. Her medications included estradiol, propafenone, digoxin, atenolol, aspirin, and fluoxetine. (Source: The Journal of Emergency Medicine)

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  Irbesartan and hydrochlorothiazide association in the treatment of hypertension.

Authors: Derosa G, Ferrari I, Cicero AF Blood pressure (BP) is one of the most important and common vascular risk factors but it is often poorly controlled. Inhibition of the renin-angiotensin-aldosterone system (RAAS) provides beneficial effects in hypertensives. The association of low-dosed diuretics in combination with RAAS blocking agents allows maximum benefit from potassium depletion and control of compensatory increase in renin secretion, so increasing the efficacy and safety of RAAS blockers. Irbesartan is a potent and selective angiotensin II subtype 1 receptor antagonist indicated for use in patients with hypertension, including those with type 2 diabetes mellitus and nephropathy. Once-daily irbesartan administration provides 24h control of BP. In patients with mild-to-modera...

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  Health News of the Day

is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.Late Bedtimes Linked to Heart Disease: Men who go to bed after midnight have significantly more hardening of the arteries. The fewer hours a man slept each night, the higher his BMI, blood pressure, and triglyceride levels, a study showed http://bit.ly/fiYXPolypill (called Plycap = thiazide, atenolol, ramipril, simvastatin, aspirin) promising in cutting heart risks http://bit.ly/16gA2hPolymeal: Diet of wine and chocolate, fish, almonds, and garlic might cut heart risk by more than 75% http://bit.ly/KSX8THeavy use of marijuana may trigger psychosis http://bit.ly/xAvj4TASER shot to the head ...

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  Prognostic Value of Changes in the Electrocardiographic Strain Pattern During Antihypertensive Treatment. The Losartan Intervention for End-Point Reduction in Hypertension Study (LIFE).

Conclusions-Development of new ECG strain is associated with an increased risk of cardiovascular morbidity and mortality and of all-cause mortality in the setting of antihypertensive therapy and regression of ECG left ventricular hypertrophy. PMID: 19332468 [PubMed - as supplied by publisher] (Source: Circulation)

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  Determination of pharmaceutical compounds in hospital effluents and their contribution to wastewater treatment works.

Authors: Langford KH, Thomas KV A method was developed for the simultaneous determination of almost 40 pharmaceuticals; including antidepressants, non-steroidal anti-inflammatories, analgesics, hypolipidemics, alpha- and beta-blockers, an anti cancer drug, anti-fungal agents, an opiate, an antibiotic, an anti-coagulant, a diuretic, an anti-anginal and an anti-diabetic compound. This was used to assess the contribution of pharmaceuticals originating from hospital effluents to one of Oslo city's wastewater treatment works. Some pharmaceuticals were found to contribute to more of the wastewater loading than others. 11% of the propranolol entering the wastewater treatment works stems from hospital effluent, approximately 2% of the atenolol, carbemazepine, metaprolol and atorvastatin, and f...

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  Circulating adrenaline released by sympathoadrenal activation elicits acute vasodilatation in the rat masseter muscle.

Authors: Ishii H, Niioka T, Izumi H The present study was designed to examine the effects of circulating catecholamines released by sympathoadrenal system on the haemodynamics of the masseter muscle in deeply urethane-anaesthetized, artificially ventilated, cervically vagotomized and sympathectomized rats. Intravenous administration of adrenaline induced a biphasic change of blood flow in the masseter muscle (MBF). The change of blood flow showed an initial marked increase and successive slight decrease in a dose-dependent manner (0.01-1mug/kg). The administration of noradrenaline had no significant effect on the MBF. The increase in the MBF evoked by exogenously applied adrenaline was markedly reduced by the intravenous administration of propranolol (100mug/kg), whereas pretreatment w...

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  Reversed-phase liquid chromatographic determination of enantiomers of atenolol in rat plasma using derivatization with Marfey's reagent.

Authors: Bhushan R, Tanwar S An HPLC method was established for enantioseparation of (R,S)-atenolol (ATE) and determination of enantiomers in rat plasma. Marfey's reagent (1-fluoro-2,4-dinitrophenyl-5-L-alanine amide, FDNP-L-Ala-NH(2), MR) was used as chiral derivatizing reagent with detection of diastereomers at 340 nm. It was shown that the R-isomer eluted before the S-isomer. The method was validated for linearity, repeatability, limits of detection and limit of quantification (LOQ). Recovery of ATE at LOQ was 92.8% for (R)-ATE and 92.6% for (S)-ATE. Copyright (c) 2009 John Wiley & Sons, Ltd. PMID: 19309763 [PubMed - as supplied by publisher] (Source: Biomedical Chromatography : BMC)

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  Minimally invasive ablation of a migrating focus of inappropriate sinus tachycardia

A 31-year-old echocardiography technician experienced tachycardia after pregnancy 3 years before presentation. The patient reported symptoms of dizziness, shortness of breath, and fatigue. An echocardiogram revealed an ejection fraction of 65% and mild mitral valve prolapse. Twenty-four-hour Holter monitoring showed a resting heart rate between 70 and 175 beats/min with rare premature ventricular complexes and rare atrial premature complexes with no evidence of sinoatrial or atrioventricular nodal block. Metoprolol, atenolol, sotalol, digoxin, and amiodarone therapy had failed. Prior catheter-based ablation attempts had mapped the focus of tachycardia laterally at the superior vena cava and right atrial junction. The catheter ablation attempts were able to modify the heart rate; however, t...

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  Impact of diabetes on treatment-induced changes in left ventricular structure and function in hypertensive patients with left ventricular hypertrophy. The LIFE study.

CONCLUSION: Among hypertensive patients with LVH, diabetes is associated with more residual LVH and less improvement in systolic LV function by echocardiography over 4.8 years of antihypertensive treatment. PMID: 19303268 [PubMed - as supplied by publisher] (Source: Nutrition, Metabolism, and Cardiovascular Diseases : NMCD)

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  Mechanisms underlying the nociceptive responses induced by platelet-activating factor (PAF) in the rat paw.

Authors: Marotta DM, Costa R, Motta EM, Fernandes ES, Medeiros R, Quintão NL, Campos MM, Calixto JB Platelet-activating factor (PAF) is an inflammatory mediator widely known to exert relevant pathophysiological functions. However, the relevance of PAF in nociception has received much less attention. Herein, we have investigated the mechanisms underlying PAF-induced spontaneous nociception and mechanical hypersensitivity in the rat paw. PAF injection (1- 30 nmol/paw) resulted in a dose-related overt nociception, whilst only the dose of 10 nmol/ paw produced a significant and time-related mechanical hypersensitivity. Local coinjection of PAF antagonist WEB2086 significantly inhibited both spontaneous nociception and mechanical hypersensitivity. Moreover, the coinjection of the natur...

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  Ivabradine plus beta blockers effective for angina patients

Ivabradine 7.5 mg twice daily in combination with atenolol was well tolerated and had greater anti-ischemic and anti-anginal efficacy than atenolol alone in patients with chronic stable angina, researchers report. (Source: MedWire News - Cardiology)

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  Delivery of a classical antihypertensive agent through the skin by chemical enhancers and iontophoresis

Oral therapy with antihypertensive agents is generally associated with severe GI side effects and low patient compliance. Therefore, development of a method of drug delivery that maintains the proper drug level for a prolonged period without adverse effects is required. Thus, transdermal delivery has all the necessities that are required for delivery of classical antihypertensive agents. However, the different approaches to enhance the transport of atenolol through intact skin have not resulted in a remarkable improvement. The effect of the drug concentration and a binary system (water[ndash]ethanol) on the atenolol flux was investigated. Further, the effects of chemical enhancers (menthol, oleic acid, polyethylene glycol 400, sodium lauryl sulphate, di methyl formamide and N-methyl-2-pyrr...

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  Effects of losartan compared with atenolol on lipids in patients with hypertension and left ventricular hypertrophy: the Losartan Intervention For Endpoint reduction in hypertension study.

Page: 567DOI: 10.1097/HJH.0b013e32831daf96Authors: Olsen, Michael Hecht a; Wachtell, Kristian b; Beevers, Gareth c; Dahlof, Bjorn d; de Simone, Giovanni e; Devereux, Richard B f; de Faire, Ulf g; Fyhrquist, Frej h; Ibsen, Hans a; Kjeldsen, Sverre E i; Lederballe-Pedersen, Ole j; Lindholm, Lars H k; Lyle, Paulette A l; Nieminen, Markku S h; Omvik, Per m; Oparil, Suzanne n; Wedel, Hans o (Source: Journal of Hypertension)

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  Efficacy of the If current inhibitor ivabradine in patients with chronic stable angina receiving beta-blocker therapy: a 4-month, randomized, placebo-controlled trial

Conclusion The combination of ivabradine 7.5 mg b.i.d. and atenolol at the commonly used dosage in clinical practice in patients with chronic stable angina pectoris produced additional efficacy with no untoward effect on safety or tolerability. (Source: European Heart Journal)

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  Pharmacogenomics of antihypertensive drugs: Rationale and design of the Pharmacogenomic Evaluation of Antihypertensive Responses (PEAR) study.

CONCLUSIONS: Pharmacogenetic-guided therapy holds clinical potential for hypertension, but the literature in the field is limited. This trial will add substantially to our understanding of the genetic determinants of antihypertensive and adverse metabolic responses to 2 commonly used antihypertensive drug classes. PMID: 19249413 [PubMed - in process] (Source: American Heart Journal)

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  Pharmacogenomics of antihypertensive drugs: Rationale and design of the Pharmacogenomic Evaluation of Antihypertensive Responses (PEAR) study.

CONCLUSIONS: Pharmacogenetic-guided therapy holds clinical potential for hypertension, but the literature in the field is limited. This trial will add substantially to our understanding of the genetic determinants of antihypertensive and adverse metabolic responses to 2 commonly used antihypertensive drug classes. PMID: 19249413 [PubMed - in process] (Source: American Heart Journal)

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  The corporate bias and the molding of prescription practices: the case of hypertension.

Authors: Fuchs FD Drug management of hypertension has been a noticeable example of the influence of the pharmaceutical industry on prescription practices. The worldwide leading brands of blood pressure-lowering agents are angiotensin receptor-blocking agents, although they are considered to be simply substitutes of angiotensin-converting enzyme (ACE) inhibitors. Commercial strategies have been based on the results of clinical trials sponsored by drug companies. Most of them presented distortions in their planning, presentation or interpretation that favored the drugs from the sponsor, i.e., corporate bias. Atenolol, an ineffective blood pressure agent in elderly individuals, was the comparator drug in several trials. In a re-analysis of the INSIGHT trial, deaths appeared to have been c...

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  Lipid emulsion may augment early blood pressure recovery in a rabbit model of atenolol toxicity.

Authors: Cave G, Harvey M PMID: 19343827 [PubMed - in process] (Source: Journal of Medical Toxicology)

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  Nebivolol: a third-generation beta-blocker for hypertension.

CONCLUSIONS: Nebivolol is a cardioselective beta-blocker that has been reported to be efficacious and well tolerated for achieving BP control in patients with hypertension. Preliminary evidence suggests a potential for reduced mortality in patients with heart failure. PMID: 19393838 [PubMed - indexed for MEDLINE] (Source: Clinical Therapeutics)

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  Direct detection of analyte binding to single molecularly imprinted polymer particles by confocal Raman spectroscopy.

We describe the use of Raman spectroscopy to detect and quantify, for the first time, the presence of the imprinting template in single molecularly imprinted polymer microspheres. The polymers were imprinted with the beta-blocking drugs propranolol and atenolol, and precipitation polymerization was used to obtain spherical particles of diameters of 200nm and 1.5mum. The size of the Raman laser spot being between 1mum and a few mum, the nanoparticles were used for bulk detection whereas with micrometer-sized particles, quantitative measurements on single particles were possible. The laser power, and consequently the acquisition times, needed to be adapted as a function of the polymer and template used in order to avoid burning. Analyte quantification from Raman spectra is straightforward by...

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  A beneficial effect of 3-year spironolactone therapy supplementing atenolol therapy on the remodeling of atria and ventricles in a patient with permanent atrial fibrillation

Content Type Journal ArticleCategory CE - Letter to the EditorDOI 10.1007/s11739-009-0229-4Authors Rafał Dąbrowski, Institute of Cardiology II Ischemic Heart Disease Department Spartańska 1 02-637 Warsaw PolandCezary Sosnowski, Institute of Cardiology I Ischemic Heart Disease Department Spartańska 1 02-637 Warsaw PolandEwa Michalak, Institute of Cardiology Department of Adult Congenital Heart Disease Alpejska 42 04-628 Warsaw PolandHanna Szwed, Institute of Cardiology II Ischemic Heart Disease Department Spartańska 1 02-637 Warsaw Poland Journal Internal and Emergency MedicineOnline ISSN 1970-9366Print ISSN 1828-0447 (Source: Internal and Emergency Medicine)

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  Investigation of some factors contributing to negative food effects

In this study, the role of biopharmaceutical factors that contribute to negative food effects was studied using furosemide, nadolol, tacrine and atenolol (as model compounds exhibiting negative food effects), and prednisolone, hydrochlorothiazide and ibuprofen (as model compounds that do not show any food effects). The physiological pH of the upper intestinal tract is lower, at pH 5, in the postprandial state when compared with the preprandial state, pH 6.5. Drugs that exhibited negative food effects had low apical to basolateral Caco-2 permeabilities, low pKa/pKb and Log P values of less than 1. The drugs exhibiting negative food effects had low distribution coefficients at the pH conditions of the fed and fasted states. Furosemide, being a hydrophilic, poorly soluble acidic drug showed l...

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  CLINICAL PRACTICE: Epistaxis

A 61-year-old man presents to the emergency room with left-sided epistaxis that has continued for 1 hour. He estimates having lost approximately 1/2 cup of blood and reports no history of nasal obstruction, epistaxis, trauma, bleeding diathesis, or easy bruising. He has a history of hypertension. Medications include atenolol and baby aspirin. How should this patient be evaluated and treated? (Source: New England Journal of Medicine)

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  Coronary heart disease benefits from blood pressure and lipid-lowering.

CONCLUSIONS: CHD benefits associated with BP and lipid lowering were larger than predicted by previous observational and trial data. We estimate that compared with pre-trial treatment, treating about 55 patients with the amlodipine-based regimen and atorvastatin would prevent one CHD event per year. PMID: 19232755 [PubMed - as supplied by publisher] (Source: International Journal of Cardiology)

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  Recruitment of cardiac parasympathetic activity: effects of clonidine on cardiac vagal motoneurones, pressure lability, and cardiac baroreflex slope in rats

Conclusions Following peripheral beta-blockade, clonidine activated CVMs from a very low baseline, increased the slope of the cardiac baroreflex and sinus arrhythmia, and reduced pressure lability. (Source: British Journal of Anaesthesia)

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  The combination of atenolol and amlodipine is better than their monotherapy for preventing end-organ damage in different types of hypertension in rats.

In conclusion, beta-blocker and amlodipine combination exerts a superior effect on blood pressure, blood pressure variability, baroreflex sensitivity and end-organ damage. The superior effect of the combination was observed in all four models of hypertension. PMID: 19220584 [PubMed - as supplied by publisher] (Source: J Cell Mol Med)

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  Chiral separations of some beta-adrenergic agonists and antagonists on AmyCoat column by HPLC.

Authors: Ali I, Saleem K, Gaitonde VD, Aboul-Enein HY, Hussain I Sixteen beta-adrenergic antagonists namely acebutalol, alprenolol, atenolol, bisoprolol, bopindolol, bufurolol, carazolol, celiprolol, indenolol, metaprolol, nebivolol, oxprenolol, practolol, propranolol, tertalol, and timolol, and two beta-adrenergic agonists namely cimeterol and clenbuterol were resolved on AmyCoat (150 x 46 mm, 3 mum size of silica particle) by using (85:15:0.1, v/v/v), (90:10:0.1, v/v/v), and (95:05:0.1, v/v/v) combinations of n-heptane, ethanol, and diethylamine solvents, respectively. The flow rates used were 0.5, 1.0, 2.0, and 3.0 ml/min with detection at 225 nm. The values of capacity, separation, and resolution factors ranged from 0.38 to 19.70, 1.08-2.33, and 1.0 and 4.50, respectively. The maxi...

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  In-vitro relationship between protein-binding and free drug concentrations of a water-soluble selective beta-adrenoreceptor antagonist (atenolol) and its interaction with arsenic.

Authors: Alam MA, Awal MA, Subhan N, Mostofa M The degree of binding of a drug to plasma proteins has a marked effect on its distribution, elimination, and pharmacological effect since only the unbound fraction is available for distribution into extra-vascular space. The protein-binding of atenolol was measured by equilibrium dialysis in the bovine serum albumin (BSA). Free atenolol concentration was increased due to addition of arsenic which reduced the binding of the compounds to BSA. During concurrent administration, arsenic displaced atenolol from its high-affinity binding Site I, and free concentration of atenolol increased from 4.286 +/- 0.629% and 5.953 +/- 0.605% to 82.153 +/- 1.924% and 85.486 +/- 1.158% in absence and presence of Site I probe respectively. Thus, it can be sug...

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  The applied pharmacology of beta-adrenoceptor antagonists (beta blockers) in relation to clinical outcomes

Summary  Despite the fact that beta blockers were introduced into clinical practice 25 years ago, new beta blockers with differing kinetic and dynamic profiles continue to be developed and marketed. This overview assesses some of the more extensively studied agents from the point of view of proof of utility and the validity of claims for therapeutic advances. The clinical data suggests that despite the expectations of improvements based on kinetic and dynamic consideration, none of the newer agents have been shownunequivocally, either in terms of efficiency or tolerability, to be an advance over the reference agents, the beta1 antagonists atenolol and metroprolol. This may be either because such improvements will not occur or because of shortcomings in the design and duratio...

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  Lisinopril versus atenolol: Decrease in systolic versus diastolic blood pressure with converting enzyme inhibition

Summary  In a multicenter, parallel, double-blind study, lisinopril, a new converting enzyme inhibitor, was compared with atenolol in the treatment of mild to moderate essential hypertension. Four hundred ninety patients were randomized to once-a-day treatment with lisinopril 20 mg or atenolol 50 mg for 4 weeks, and the doses of lisinopril or atenolol were increased at 4-week intervals up to 80 mg or 200 mg, respectively, if sitting diastolic blood pressure (SDBP) was not well controlled. Lisinopril and atenolol reduced SDBP to a similar extent. All reductions from baseline in sitting diastolic and systolic blood pressure were significant (p < 0.01). Lisinopril produced a significantly greater reduction (p < 0.01) in sitting systolic blood pressure (SSBP) than atenolo...

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  Blood Pressure Response Under Chronic Antihypertensive Drug Therapy: The Role of Aortic Stiffness in the REASON (Preterax in Regression of Arterial Stiffness in a Controlled Double-Blind) Study

Conclusions Baseline PWV is a significant predictor of BP response to antihypertensive treatment, independent from age, the need for increasing drug dosage, and the presence of cardiovascular risk factors. Achievement of SBP control appears to be influenced by aortic stiffness as well as by angiotensin-converting enzyme inhibition. (Source: Journal of the American College of Cardiology)

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  The Effect of Antihypertensive Drugs on Central Blood Pressure Beyond Peripheral Blood Pressure. Part II: Evidence for Specific Class-Effects of Antihypertensive Drugs on Pressure Amplification.

Authors: Protogerou AD, Stergiou GS, Vlachopoulos C, Blacher J, Achimastos A The blood pressure (BP) waveform varies substantially between the peripheral conduit (brachial) and the central elastic (aorta) arteries mainly do a gradual increase of systolic BP, as the wave propagates distally. This phenomenon is called BP amplification and is principally generated by the presence of arterial stiffness gradient and wave reflections along the arterial bed. More and more clinical studies suggest that central BP may provide additional information regarding cardiovascular risk beyond peripheral BP. Arterial properties and thus pressure amplification, are modulated by age, cardiovascular risk factors, vasoactive substances and drugs. Recent evidence suggests, beyond any doubt, that antihyperten...

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  Health News of the Day

I subscribe to 400-500 RSS feeds in Google Reader which produce about 3,000 items per day. Many of them are health news feeds and I share the ones I find particularly interesting on Twitter. Those are usually the tweets that bring the most replies and re-tweets which probably means that they resonate with my 500+ medically-inclined Twitter subscribers ("followers").From today, I will publish a daily summary of the health news here, made from the selected links posted on Twitter. It will be in "bullet points only" format and will always link to the original source. Those who have read this blog since 2005 know that I always link to the source at the end of every blog in a clearly visible and designated "References" section.Micro-blogging (Twitter) and blogging (CasesBlog) are related in ter...

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  Atrial Fib Risk Went Up With Rising Heart Rate in LIFE Hypertension Trial

The link between heart rate and risk of AF was independent of treatment group in a subanalysis of the trial, which compared antihypertensive regimens based on losartan or atenolol. Heartwire (Source: Medscape Medical News Headlines)

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  Prognostic importance of hemoglobin in hypertensive patients with electrocardiographic left ventricular hypertrophy: the Losartan Intervention For End point reduction in hypertension (LIFE) study.

CONCLUSIONS: After adjusting for other risk factors, relatively low, but not high, hemoglobin during antihypertensive treatment was associated with higher incidence of all-cause mortality and the composite end point. PMID: 19081416 [PubMed - in process] (Source: American Heart Journal)

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  ORIGINAL INVESTIGATION: Comparative Effectiveness of Different {beta}-Adrenergic Antagonists on Mortality Among Adults With Heart Failure in Clinical Practice

Conclusions  Compared with atenolol, the adjusted risks of death were slightly higher with shorter-acting metoprolol tartrate but did not significantly differ for carvedilol in adults with heart failure. Our results should be interpreted cautiously and they suggest the need for randomized trials within real-world settings comparing a broader spectrum of β-blockers for heart failure. (Source: Archives of Internal Medicine)

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  Characterization of atenolol transformation products on light-activated TiO(2) surface by high-performance liquid chromatography/high-resolution mass spectrometry.

Authors: Medana C, Calza P, Carbone F, Pelizzetti E, Hidaka H, Baiocchi C PMID: 19061206 [PubMed - as supplied by publisher] (Source: Rapid Communications in Mass Spectrometry : RCM)

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Top Viagra Store

A first shop in the series of one-pill shops is rightfully viagra-targeted. The index page offers only Viagra, both generic and original.It is possible to purchase other ED products from other pagers, but the main accent is on Viagra.

top-viagra-store.com

Indian Meds

A most recent indian-themed, ethnic site. Includes generic and original (brand) products. al our standard navigational tools and support options are available. This site converts nicely on general pharmaceutical traffic as it has products for vurtually any need.

indianmeds.org

Friendly ED Pharmacy

Many ED customers are anxious about the status their orders. This special friendly site is here to solve the problem. "State of the art" design features high usability and clearly visible support options. All this helps to satisfy even the most demanding customer and results in increased sales ratio.

friendly-ed-pharmacy.com

Popular ED Products

This ED site offers simplistic design that gets right to the point - this IS the site for ED. Popular ED list the top selling products and converts best on ED-targeted, pill-specific traffic.

popular-ed-products.com

Perfect ED Store

This site is just right for ED customers. All ED products are conveniently listed at main page, allowing to make an easy choice. Our regular Sample Pills Offer is emphasized here. Customers can try new products and are likely to return for more refills.

perfect-ed-store.com

Worlds Best Pharmacy

The name says it all. This is the best online pharmacy on the web. The index page is set to show the most polular ED products, while the menu and quicksearch allow to find products in other categories.

worlds-best-pharmacy.com

Delhi Drugs

This Indian-themed site offers a completely new design. All our generic products are availabe and can easily be located with the help of quicksearch feature. Includes our latest shopping engine and billing page.

www.delhi-drugs.com

Indian Generics

Many customers are looking for Indian drugs, and this site is designed specifically for such customers. It includes many generic products, modern design, translated into 7 languages and prices in both USD and Euros. Also it uses our latest shopping engine and billing page.

www.indian-generics.com