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HomeHealth articlesatenololWhat Is Atenolol and Its Impact on Heart?

Atenolol Silent Ischemia Study

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Atenolol is a drug that reduces blood pressure and is used for hypertensive patients and to treat daily ischemia (reduced blood supply).

Medically reviewed by

Dr. Muhammad Zohaib Siddiq

Published At May 24, 2023
Reviewed AtFebruary 8, 2024


A decrease in the supply of blood is called ischemia. Myocardial (heart) ischemia occurs when blood flow to the heart is reduced, preventing the heart from receiving sufficient oxygen. It is due to reduced partial or complete blockage of the heart's blood vessels (coronary arteries). Cardiac ischemia reduces the heart muscle's ability to pump blood. Severe blockage in the heart's blood vessels can lead to a heart attack. Myocardial ischemia might also cause serious abnormal heart rhythms. Treatment for myocardial ischemia involves improving blood flow, including angioplasty or coronary bypass graft surgery.

What Is Atenolol?

Atenolol is a beta-blocker that affects blood flow through the arteries and veins of the heart. Atenolol treats chest pain (angina) and high blood pressure. It also lowers the risk of death after severe heart disease. Atenolol is used during serious heart conditions such as slow heartbeat and heart failure. It causes side effects, like thinking and reasoning, that can affect brain activity. Atenolol is only part of a program of treatment for hypertension. It is very important to maintain a proper diet, medication, and exercise routines closely if someone is getting treated for high blood pressure. High blood pressure usually has no symptoms. It is necessary to use blood pressure medication for the rest of your life.

What Are Beta Blockers?

Beta-blockers, also known as beta-adrenergic blocking agents, are medications that reduce blood pressure. It causes the heart to beat slowly and with less force, lowering blood pressure. Beta-blockers also help widen veins and arteries.

What Are Examples of Beta Blockers?

The following are examples of beta-blockers:

  • Acebutolol.

  • Atenolol.

  • Bisoprolol.

  • Metoprolol.

  • Nadolol.

  • Nebivolol.

  • Propranolol.

  • Beta-blockers are not prescribed as a first treatment in people with only high blood pressure. Beta-blockers, such as diuretics, are not prescribed frequently for high blood pressure patients, which have not worked well. Beta-blockers are prescribed as one of several medications to lower blood pressure.

Beta-blockers are used to prevent, treat or improve symptoms in people who have:

  • Irregular heartbeat (arrhythmia).

  • Heart failure.

  • Chest pain (angina).

  • Heart attack.

  • Migraine.

  • Beta-blockers are generally not used in people with asthma because they can trigger asthma attacks. People with diabetes block signs of low blood sugar, such as rapid heartbeat. It is important to check the blood sugar regularly if they have diabetes and are taking a beta-blocker.

  • Beta-blockers can affect cholesterol and triglyceride levels. It causes a mild rise in triglycerides and a mild decrease in good cholesterol or high-density lipoprotein (HDL) cholesterol.

  • One should not abruptly stop taking a beta-blocker because it causes the risk of a heart attack or other heart problems.

What Are the Risk Factors That Have to Be Considered Before Taking Atenolol?

The following are the risk factors that have to be considered before taking atenolol-

  • Congestive heart failure.

  • Asthma.

  • Bronchitis (inflammation of the bronchial tubes of the lungs).

  • Emphysema (shortness of breath).

  • Diabetes.

  • Thyroid problem.

  • Liver disease.

  • Kidney disease.

  • Pheochromocytoma (abnormal growth in the adrenal gland).

  • Allergies (like skin allergies).

How Should Atenolol Be Used?

Atenolol should be used in the following ways:

  • Atenolol should be withdrawn gradually. The dosage should be withdrawn gradually over 7 to 14 days to reduce the beta-blocker dosage. Especially the patients with ischemia (restriction in blood supply), the medication should be withdrawn slowly.

  • When a patient is advised for surgery and discontinues beta-blocker therapy, it should be done at least 24 hours before the procedure. The risk-benefit assessment of stopping Atenolol is made for each patient. If treatment is continued, an anesthetic should be selected to decrease the risk of myocardial depression (heart muscle depression).

  • Atenolol is not used in severe heart failure. It can be used in patients with signs of heart failure that have been controlled. It should be used cautiously in people with poor cardiac (heart) functions. Because of its negative effect on conduction time, it should be used cautiously in patients with first-degree heart block. It can mask the symptoms of hypoglycemia, particularly tachycardia (fast heartbeat). It can mask the signs of thyrotoxicosis (a state of high levels of circulating thyroid hormones).

  • Atenolol will reduce the heart rate as a result of its pharmacological action. Sometimes, the dose should be reduced when a treated patient develops a slow heart rate, and the pulse rate is less than 50 to 55 beats per minute at rest.

  • It can cause more severe reactions to various allergens when given to patients with allergic reactions. Such patients may be unresponsive to the doses of adrenaline (epinephrine) used to treat allergic reactions.

  • It can cause a hypersensitivity reaction. Atenolol is excreted through the kidneys. The dosage is reduced in patients with a creatinine clearance below 35 milliliters per minute per 1.73 m2.

  • Occasionally, some increase in airway resistance may occur in asthmatic patients. A dosage of bronchodilators such as Salbutamol or Isoprenaline usually reverses this.

  • This medicine contains less than one millimole of sodium (23 milligrams) per tablet, essentially 'sodium-free.'

What Are the Interactions of Atenolol With Other Medications?

The interactions of Atenolol with other medications include:

  • Beta-blockers and calcium channel blockers, such as Verapamil and Diltiazem, can decrease blood pressure, particularly in patients with impaired ventricular function and sinoatrial or atrioventricular conduction abnormalities. It can result in severe hypotension (low blood pressure), bradycardia (less heartbeat), and heart failure. Beta-blockers and calcium channel blockers should be administered within 48 hours of discontinuing the other.

  • Combining Atenolol with Dihydropyridines, such as Nifedipine, can increase the risk of hypotension and heart failure.

  • Digitalis glycosides, combined with beta-blockers, may increase atrioventricular conduction time.

  • Beta-blockers may exacerbate the rebound hypertension, which follows the withdrawal of Clonidine. If the two drugs are co-administered, the beta-blocker should be withdrawn several days before discontinuing clonidine. If replacing clonidine with beta-blocker therapy, the introduction of beta-blockers should be delayed.

  • Antiarrhythmic drugs and amiodarone may potentiate atrial conduction time and induce a negative inotropic effect. Using sympathomimetic agents, for example, adrenaline (epinephrine), may counteract the beta-blockers effect.

  • Concomitant use of insulin and oral antidiabetic drugs increases the blood sugar-lowering effects of these drugs. Symptoms of hypoglycemia, like high blood pressure, are masked.

  • Using prostaglandin synthetase-inhibiting drugs, such as Ibuprofen and Indometacin, can decrease the hypotensive effects of beta-blockers.

  • Anesthetics should be used carefully with Atenolol. Beta-blockers with anesthetic drugs may increase reflex tachycardia (high heart rate) and the risk of low blood pressure. Anesthetic agents causing myocardial depression should be avoided.

What Are the Side Effects of Atenolol?

Atenolol's most common side effects include cold extremities (feeling extremely cold), fatigue, slow heart rate, nausea, vomiting, diarrhea, and tiredness. They are usually mild and short-lived; not everyone will experience these side effects.


In addition to atenolol, treatment of high blood pressure includes weight control and changes in diet. But lifestyle changes, a good diet, and constant motivation can prevent all odds. Consulting a doctor and taking treatment is the best option. Under the expert guidance of the physician and by following a healthy lifestyle with the required modification, one can recover from cardiovascular diseases.

Dr. Muhammad Zohaib Siddiq
Dr. Muhammad Zohaib Siddiq



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