Beta-adrenergic-receptor blockers and antinuclear antibodies in hypertension

It has recently been reported that the Beta-adrenergic receptor-blocker acebutolol accelerates the development of antinuclear antibodies (ANAs) in hypertensive patients. We examined data from over 1500 hypertensive patients to determine whether this effect is associated with other beta blockers. Groups of patients treated with acebutolol, atenolol, labetalol, and pindolol all displayed increased development of ANAs relative to patients on other medication. When patients taking methyldopa (a drug associated with a high ANA incidence) were excluded from the analysis, only acebutolol retained an association (P less than 0.001) with ANA production. Sequential studies to assess the development of ANAs in patients during the course of beta-blocker treatment revealed a similar pattern. With methyldopa patients excluded, the fraction of patients developing ANAs was less then 10% for all but atenolol (10.9%), labetalol (13.8%), and acebutolol (33%). Thus, although some of the beta blockers may be associated with an increase in ANA incidence, the dramatic effects of acebutolol do not appear to be a group property.