How Effective Is Atenolol for Hypertension?

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  • Written By: Mary McMahon
  • Edited By: Shereen Skola
  • Last Modified Date: 14 October 2019
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Careful scientific analysis of the use of atenolol for hypertension indicates this drug may not be as effective as was once believed. It was historically a common choice of first line treatment for patients with high blood pressure. Researchers in the early 2000s examined patient outcomes with this medication and suggested that it might fail to lower blood pressure and could put patients at risk of complications. Unlike some other hypertension drugs, it does not appear to have a cardioprotective effect, which is a cause for concern.

This drug is among a class of medications called beta blockers. It works by lowering the heart rate, which in turn can reduce strain on the heart. Theoretically, lowering the heart rate should also reduce blood pressure. Patients taking atenolol for hypertension, however, can still experience a high central pressure where the thoracic vena cava returns blood to the heart. High central pressure can lead to cardiac strain, which can be dangerous.

Patients on beta blockers have long been made aware of potential risks of the medications, including cardiac events and dangerous drug interactions. Physicians reviewing literature on this subject suggests that atenolol may be a culprit behind high complication rates; rather than being side effects of all beta blockers, these could be issues specific to this medication. If this is the case, as several studies seem to support, taking atenolol for hypertension may not be effective and could put the patient at increased risk of serious complications.


High blood pressure can increase the risk of stroke, heart attack, and other adverse health events, which is one reason doctors recommend getting it under control. Medications to treat hypertension should both lower blood pressure and protect the heart. Analysis of atenolol for hypertension suggests that the medication does not carry cardiac benefits, and may not be the best choice for patients with high blood pressure. It can be useful in the management of other conditions, however, and evidence does not support a recommendation to remove it from the market entirely.

The outcome of research on this drug and its effects highlights the fact that simply slowing the heart may not necessarily improve blood pressure. Atenolol for hypertension may be appropriate in combination therapy where the patient plans to take other medications, along with some additional protective measures, to address concerns about heart health. On its own, it may not be the safest and most effective choice.


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Post 4

I experienced exhaustively vivid dreams from the new generation beta blockers, which are lipophilic, and effect the central nervous system. Atenolol is one of the few water soluble beta blockers.

Post 3

Beta blockers like atenolol are not bad drugs and they're definitely not ineffective. They're just not always the preferred treatment for hypertension. Sometimes, they are the best treatment and other times, calcium channel blockers or ACE inhibitors are better suited. It depends on the patient, the extent of the hypertension and the kind of damage that the hypertension has caused.

I don't think that we can write off atenolol as a hypertension treatment just yet. But it's important for doctors to consider many different factors when treating hypertension.

Post 2

@alisha-- I have no idea. I'm on atenolol right now and I'm checking my blood pressure at home regularly with a monitor. My blood pressure is normal, so the medication is definitely working.

Post 1

I think atenolol might be the reason why I have high eye pressure due to hypertension despite being on medication.

I was diagnosed with hypertension fifteen years ago. I was prescribed atenolol at that time and used it regularly until five years ago when my doctor switched me to a different medication.

Now I have something called high eye pressure which is usually related to high blood pressure and which can cause serious eye nerve damage if not treated. It's odd that I've developed this despite being on medications for hypertension for so long. I wonder if the atenolol was not reducing my blood pressure as it should have been during those ten years, which has now lead to this complication?

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