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Atenolol en la hipertensión: ¿es una buena opción?
Bo Carlberg1, Ola Samuelsson, Lars Hjalmar Lindholm
1Department of Public Health and Clinical Medicine, Umeå University Hospital, SE 901 85 Umeå, Sweden.
Lancet (London, England)
|November 9, 2004
Resumen
Atenolol (un bloqueador beta) no mejoró los resultados en comparación con el placebo en pacientes con hipertensión. Sin embargo, mostró una mayor mortalidad y riesgo de accidente cerebrovascular que otros antihipertensivos, cuestionando su uso.
Área de la Ciencia:
- Cardiología Cardiología.
- Farmacología Farmacología.
- Los ensayos clínicos son ensayos clínicos.
Sus antecedentes:
- Atenolol es un bloqueador beta ampliamente utilizado para la hipertensión.
- Se cuestiona su idoneidad como fármaco de referencia en ensayos clínicos.
Objetivo del estudio:
- Revisar sistemáticamente los efectos del atenolol en la morbilidad y mortalidad cardiovascular en pacientes hipertensos.
Principales métodos:
- Revisión sistemática y metanálisis de ensayos controlados aleatorios.
- Las búsquedas incluyeron la Biblioteca Cochrane, MEDLINE y la comunicación de expertos.
- Los ensayos incluidos compararon el atenolol con placebo u otros antihipertensivos.
Principales resultados:
- En comparación con el placebo, el atenolol no mostró diferencias significativas en la mortalidad por cualquier causa, la mortalidad cardiovascular o el infarto de miocardio.
- El atenolol se asoció con una tendencia hacia un menor riesgo de accidente cerebrovascular frente al placebo.
- En comparación con otros antihipertensivos, el atenolol demostró una mortalidad significativamente mayor y un aumento de la frecuencia del accidente cerebrovascular.
Conclusiones:
- La eficacia y seguridad de Atenolol como tratamiento para pacientes hipertensos son cuestionables.
- Su papel como fármaco de referencia en los ensayos de resultados de la hipertensión debe ser reconsiderado.
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