The enhanced effect of atenolol on hypertension in metabolic syndrome

In metabolic syndrome, hypertension has been noted as one of the most important risk factors that contributes to cardiovascular disease. We have evaluated the effect of a selective adrenergic β(1)-receptor blocker, atenolol, on blood pressure and pulse rate in metabolic syndrome.

Metabolic syndrome patients with hypertension (n=28) and a control group (n=20) were given atenolol (50 mg/day) for 4 weeks. Blood pressure, pulse rate, and blood biochemical parameters were monitored.

Pulse rate in the metabolic syndrome group before the treatment was significantly higher than in the control group (control 74 ± 2/min, metabolic syndrome 84 ± 2/min, P<0.05). Decrease in pulse rate resulting from the treatment was greater in the metabolic syndrome group than in the control group (control 14 ± 3/min, metabolic syndrome 21 ± 2/min, P<0.05). Decrease in systolic (SBP) and diastolic (DBP) blood pressure was greater in the metabolic syndrome group than in the control group (SBP, control 8 ± 3, metabolic syndrome 23 ± 3 mmHg, P<0.05; DBP, control 6 ± 3, metabolic syndrome 13 ± 2 mmHg, P<0.05). There was a positive association between decrease in SBP and the waist measurements of patients, between the decrease in DBP and the waist measurements, and between the decrease in pulse rate and the waist measurements. We also found that there was a positive association between the decrease in SBP and initial SBP, between the decrease in DBP and initial DBP, and between the decrease in pulse rate and initial pulse rate.

These data showed that atenolol has an enhanced effect on blood pressure and on pulse rate in metabolic syndrome. It may be useful in treating severe hypertension with elevated heart rate in metabolic syndrome.