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Does atenolol differ from other beta-adrenergic blockers?Aursnes I; Osnes JB; Tvete IF; Gasemyr J; Natvig BBMC Clin Pharmacol 2007[May]; 7 (ä): 4BACKGROUND: A recent meta-analysis of drug effects in patients with hypertension claims that all beta-adrenergic blockers are equally effective but less so than other antihypertensive drugs. Published comparisons of the beta-adrenergic blocker atenolol and non-atenolol beta-adrenergic blockers indicate different effects on death rates, arrhythmias, peripheral vascular resistance and prognosis post myocardial infarction, all in disfavor of atenolol. In keeping with these findings, the data presented in the meta-analysis indicate that atenolol is less effective than the non-atenolol beta-adrenergic blockers both when compared with placebo and with other antihypertensive drugs. These findings were not, however, statistically significant. METHODS: We performed an additional analysis with a Bayesian statistical method in order to make further use of the published data. RESULTS: Our calculations on the clinical data in the meta-analysis showed 13% lower risk (risk ratio 0.87) of myocardial infarction among hypertensive patients taking non-atenolol beta-adrenergic blockers than among hypertensive patients taking atenolol. The 90 % credibility interval ranged from 0.75 to 0.99, thereby indicating statistical significance. The probability of at least 10% lower risk (risk ratio |Adrenergic beta-Antagonists/*therapeutic use[MESH]|Atenolol/*therapeutic use[MESH]|Bayes Theorem[MESH]|Humans[MESH]|Hypertension/drug therapy/epidemiology[MESH]|Meta-Analysis as Topic[MESH]|Myocardial Infarction/epidemiology/prevention & control[MESH] |
