This was question thrown at me , in one of the patient -physician meet .
“I am a 58 year old business man . I am taking tab Atenolol 50mg for over 6 years .I am comfortable with that .My BP hovers around 130 /80 mmhg .My heart rate is 64/mt . I have recently moved to a popular city in south India . Now , my cardiologist thinks Tablet Atenolol for hypertension is useless . . . what do you say sir ?
My answer went on like this . . . causing much displeasure to my colleagues !
Atenolol is a wonder drug for management of both hypertension and angina for more than 2 decades . It is still useful in majority of patients with HT .
The reason for current generation of cardiac physicians shunning away from this drug is largely for non academic reasons . A drug which is in market for more than a decade , generally becomes a generic one. Generic drugs are like orphan drugs ! and patients who consume generics are inferior ones .This is how market economics want us to think .
Physicians are sincere followers of science and science is not sacred , often times . . . it is the creation of corporate gimmicks .
Few small studies , one major publication , few guideline from influential scientific bodies , cocktail of seminars , symposiums all that is required to disseminate a concept !
The second major reason is every physician wants to behave in unique way . He fears loosing his prestige and charm if he continues the same drug prescribed by another physician . Many patients also do not like to continue the same drug for long time !
And now a few words for the cardiac scientists !
*The concept of central aortic pressure and beta blocker’s lack of control over it are all concocted .Beta blocker is most powerful agent to reduce the shearing stress in the walls of aorta . We know that and we believe in that and we prescribe it for aortic dissection to attenuate the intimal tear . Can it do this . . . without lowering central aortic pressure ? Think for a moment !
Atenol and Metoprolol : The curious companions .
Both being closely related beta blockers , what makes Atenolol to be frowned upon and still Metoprolol is alive and kicking !
My final answer to your question !
Atenolol is still useful in the management of HT. If your BP is well controlled , and you have no side effects, there is absolutely no need to change the drug . . . if you are insisted , you may consider changing your doctor . . . . . . rather !
Dr.S.Venkatesan MD 
Leave a Reply