Two common blood pressure meds fare equally in preventing heart woes

Atenolol (Tenormin) and metoprolol tartrate (Lopressor) are beta blockers that are widely used to treat high blood pressure and heart problems. Previous research has suggested that atenolol might be less effective than other high blood pressure drugs for preventing cardiovascular events in patients with high blood pressure.

In this study, researchers reviewed the medical records of nearly 121,000 U.S. patients with high blood pressure but no history of heart disease who started taking one of the two drugs between 2000 and 2009. Atenolol was used by about 10 times more patients than metoprolol.

During a follow-up averaging about five years, there was no statistically significant difference in rates of heart attack, stroke or heart failure between the two groups of patients.

"In conclusion, we found no differences in [heart] event rates ... with either atenolol or metoprolol," said review author Emily Parker, of HealthPartners Institute for Education and Research in Minneapolis, and colleagues. However, the researchers added that the findings "should be interpreted cautiously, since there have been no trials comparing these two beta blockers directly."

Two experts not connected to the study said patients have many options for treating high blood pressure.

"Like many of my colleagues, I also use beta blockers as an add-on antihypertensive strategy for those patients being treated for hypertension and not yet having other cardiac problems," said Dr. David Friedman, chief of heart failure services at North Shore-LIJ's Plainview Hospital, in Plainview, N.Y. He added, however, that "when it comes to treating blood pressure alone, beta blockers have taken a back seat to other medications such as diuretics."

Dr. Kenneth Ong is acting chair of the department of medicine and cardiology at The Brooklyn Hospital Center, in New York City. He noted that there has been debate as to whether atenolol works as well as other drugs used to fight high blood pressure.

"While the [new] study is a retrospective analysis, it suggests that there may be no merit to changing atenolol to metoprolol tartrate," he said. "It will be important to verify these findings with a randomized, prospective trial."

The review was funded by the U.S. National Heart, Lung and Blood Institute, and was published online Aug. 27 in the Archives of Internal Medicine.

More information: The U.S. National Heart, Lung, and Blood Institute has more about treatment of high blood pressure.

Journal reference: JAMA Internal Medicine

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