Class: beta-Adrenergic Blocking Agents
VA Class: CV100
CAS Number: 29122-68-7
Medically reviewed on Oct 30, 2017
Uses for Atenolol
β-Adrenergic blocking agents (β-blockers) generally not preferred for initial management of hypertension, but may be considered in patients who have a compelling indication (e.g., prior MI, ischemic heart disease, heart failure) for their use or as add-on therapy in those who do not respond adequately to the preferred drug classes (ACE inhibitors, angiotensin II receptor antagonists, calcium-channel blockers, or thiazide diuretics).237 501 502 503 504 515 523 524 527 800
Black hypertensive patients generally tend to respond better to monotherapy with calcium-channel blockers or thiazide diuretics than to β-blockers.232 259 260 500 501 504 However, diminished response to β-blockers is largely eliminated when administered concomitantly with a thiazide diuretic.500
Chronic Stable Angina
β-Blockers are recommended as first-line anti-ischemic drugs in most patients with chronic stable angina; despite differences in cardioselectivity, intrinsic sympathomimetic activity, and other clinical factors, all β-blockers appear to be equally effective for this use.1101
Non-ST-Segment-Elevation Acute Coronary Syndromes (NSTE ACS)
Used as part of the standard therapeutic measures for managing NSTE ACS, which include unstable angina and non-ST-segment-elevation MI (NSTEMI).1100
Expert guidelines recommend initiation of oral β-blocker therapy within the first 24 hours in patients who do not have manifestations of heart failure, evidence of low-output state, increased risk of cardiogenic shock, or any other contraindications to β-blocker therapy.1100
Continue β-blocker therapy for secondary prevention in patients with stabilized heart failure and reduced systolic function (preferably with bisoprolol, carvedilol, or metoprolol succinate because of proven mortality benefit).1100
Expert guidelines recommend initiation of oral β-blocker therapy within the first 24 hours in patients who do not have manifestations of heart failure, evidence of low-output state, increased risk of cardiogenic shock, or any other contraindications to β-blocker therapy.527 1100 Because of conflicting evidence of benefit and potential for harm (e.g., cardiogenic shock), experts recommend limiting use of IV β-blockers to patients with refractory hypertension or ongoing ischemia at time of presentation.527
Continue β-blocker therapy for secondary prevention in post-MI patients with left ventricular systolic dysfunction (preferably with bisoprolol, carvedilol, or metoprolol succinate because of proven mortality benefit).525 Although benefits of long-term β-blockade in patients with normal left ventricular function are less well established, experts recommend continuing β-blocker therapy for at least 3 years in such patients.525
Has been used in the treatment of supraventricular tachycardia† (SVT) (e.g., atrial flutter†, junctional tachycardia†, focal atrial tachycardia†, paroxysmal supraventricular tachycardia [PSVT]†).300 301 401
Vagal maneuvers and/or IV adenosine are considered first-line interventions for acute treatment of SVT when clinically indicated; if such measures are ineffective or not feasible, may consider an IV β-adrenergic blocking agent.300 Oral β-blockers may be used for ongoing management.300 Although evidence of efficacy is limited, experts state that overall safety of β-adrenergic blockers warrants use.300
β-Blockers have been used in patients with cardiac arrest precipitated by ventricular fibrillation† or pulseless VT†; however, routine administration after cardiac arrest is potentially harmful and not recommended.400
Not recommended for the treatment of a migraine attack that has already started.228
Atenolol Dosage and Administration
Individualize dosage according to patient response.111
BP Monitoring and Treatment Goals
When available, use evidence-based dosing information (i.e., dosages shown in randomized controlled trials to reduce complications of hypertension) to determine target dosages; target dosages usually can be achieved within 2–4 weeks but may take up to several months.501
Goal is to achieve and maintain optimal control of BP; individualize specific target BP based on consideration of multiple factors, including patient age and comorbidities, and currently available evidence from clinical studies.500 501
Once-daily dosing usually is sufficient in the management of hypertension.c
Some experts recommend an initial dosage of 0.5–1 mg/kg daily given as a single dose or in 2 divided doses.258 Increase dosage as necessary up to a maximum dosage of 2 mg/kg (up to 100 mg) daily given as a single dose or in 2 divided doses.258
JNC 8 expert panel recommends initial dosage of 25–50 mg once daily and target dosage of 100 mg once daily based on dosages used in randomized controlled studies.501
Manufacturer recommends initial dosage of 50 mg once daily, alone or in combination with a diuretic; full hypotensive effect usually seen within 1–2 weeks.600 If necessary, may increase dosage to 100 mg once daily.600
Some experts state usual dosage range is 25–100 mg daily.500
If intolerable adverse effects occur, consider dosage reduction; if adverse effects worsen or fail to resolve, may need to discontinue and switch to another antihypertensive drug class.501
Atenolol/Chlorthalidone Fixed-combination TherapyOral
Manufacturer states fixed-combination preparation is not recommended for initial therapy; administer each drug separately, then use the fixed combination if the optimum maintenance dosage corresponds to the ratio of drugs in the combination preparation.118 c
May add another antihypertensive agent when necessary (gradually using half of the usual initial dosage to avoid an excessive decrease in BP).118
Chronic Stable Angina
Initially, 50 mg once daily.111
If optimum response is not achieved within 1 week, increase to 100 mg once daily.111
Some patients may require 200 mg once daily for optimum effect.111
May initiate therapy as soon as possible after patient's hemodynamic condition has stabilized.600
Long-term Secondary PreventionOral
Optimal duration of therapy for secondary prevention remains to be clearly established.111 120 527 802 804 Experts generally recommend long-term therapy in post-MI patients with left ventricular systolic dysfunction, and at least 3 years of therapy in those with normal left ventricular function.525 802 804 1101
SVT (e.g., PSVT†, Atrial Flutter†, Junctional Tachycardia†, Atrial Tachycardia†) or Atrial Fibrillation†Oral
Prevention of Common Migraine†Oral
Dosage has not been established; in clinical studies 100 mg daily was usual effective dosage.228
Maximum 2 mg/kg (up to 100 mg) daily.258
Increasing beyond 100 mg daily usually does not result in further improvement in BP control.600
Modify doses and/or frequency of administration in response to the degree of renal impairment.c
Initial dosage of 25 mg daily may be necessary.111
Measure BP just prior to the dose to ensure persistence of adequate BP reduction.111
Patients with Clcr 15–35 mL/minute per 1.73 m2: Maximum 50 daily.111
Modification of dosage may be necessary because of age-related decreases in renal function.111
Initially, 25 mg daily may be necessary.111
Measure BP just prior to a dose to ensure persistence of adequate BP reduction.111
Initially, 50 mg daily and use lowest possible dosage.111 If dosage must be increased, consider administering in 2 divided doses daily to decrease peak blood levels.111 A β2-adrenergic agonist bronchodilator should be available.111 (See Bronchospastic Disease under Cautions.)
Cautions for Atenolol
Patients with sinus bradycardia,111 118 120 220 AV block greater than first degree,111 118 120 220 274 cardiogenic shock,111 118 120 220 overt or decompensated cardiac failure. Patients with acute MI not promptly and effectively controlled by 80 mg IV furosemide or equivalent therapy.111 118 120 220
Possible precipitation of heart failure; possible decreased exercise tolerance in patients with left ventricular dysfunction.
Initiate therapy and subsequent dosage adjustments in patients with heart failure under close medical supervision. Prior to initiation of the drug, stabilize patient on other therapy (e.g., ACE inhibitor, diuretic, and/or cardiac glycoside). Symptomatic improvement may not be evident for 2–3 months after initiating therapy.
Avoid use in patients with decompensated heart failure; use cautiously in patients with inadequate myocardial function and, if necessary, in patients with well-compensated heart failure (e.g., those controlled with ACE inhibitors, cardiac glycosides, and/or diuretics); use with extreme caution in patients with substantial cardiomegaly.
Adequate treatment (e.g., with a cardiac glycoside and/or diuretic) and close observation recommended if signs or symptoms of impending cardiac failure occur; if cardiac failure continues, discontinue therapy, gradually if possible.
History of Anaphylactic Reactions
Calcium-channel Blocking Agents
Concomitant use may cause bradycardia, heart block, increased left ventricular and diastolic blood pressure, particularly in patients with preexisting conduction abnormalities or left ventricular dysfunction.111 120 (See Specific Drugs under Interactions.)
Possible bronchoconstriction, especially at dosages >100 mg daily.c Cautious use recommended in patients with bronchospastic disease (patients who do not respond to or cannot tolerate other hypotensive agents).111 120
Initiate therapy with 50 mg daily and use lowest possible dosage; β1-selectivity is not absolute.111 120 Twice-daily dosing and concomitant use of a β2-adrenergic agonist bronchodilator may minimize risk of bronchospasm.111 120 c
Anesthesia and Major Surgery
Possible increased risks associated with general anesthesia.111 (See Specific Drugs under Interactions.)
Withdrawal of β-blocker prior to surgery is not recommended in most patients.111
Correct vagal dominance (if any) with atropine (1–2 mg IV).111
Diabetes and Hypoglycemia
Peripheral Arterial Circulatory Disorders
Atenolol shares the toxic potentials of β-blockers; observe usual precautions of these agents.c
Response in patients ≥65 years of age does not appear to differ from that in younger adults; however, use with caution due to greater frequency of decreased hepatic, renal, and/or cardiac function and of concomitant disease and drug therapy observed in the elderly.111 118 120
Consider age-related decreases in renal function when selecting dosage and adjust dosage if necessary.111 Evaluation of geriatric patients with hypertension or MI should always include assessment of renal function.111 120 (See Geriatric Patients under Dosage and Administration.)
Common Adverse Effects
Tiredness,111 120 hypotension,111 120 heart failure,111 120 bradycardia,111 113 120 124 ventricular tachycardia,111 120 dizziness,111 120 cold extremities,111 120 depression,111 120 supraventricular tachycardia (atrial fibrillation or flutter),111 120 bundle branch block and major axis deviation,111 120 fatigue,111 120 dyspnea.111 120
Interactions for Atenolol
Anesthetics, general (myocardial depressant)
Increased risk of hypotension and heart failurec
Use with caution111 (see Anesthesia and Major Surgery under Cautions)
Calcium-channel blockers (e.g., verapamil, diltiazem)
Additive hypotensive effect; may be used to therapeutic advantagec
Adjust dosage carefullyc
Catecholamine-depleting drugs (e.g., reserpine)
Additive hypotensive effect; may be used to therapeutic advantagec
Adjust dosage carefullyc
Additive or potentiated hypotensive effect; may be used to therapeutic advantagec
Adjust dosage carefully when used concurrentlyc
NSAIAs (e.g., indomethacin, aspirin)
50–60% following oral administration.c
Well distributed into most tissues and fluids except brain and CSF.c
Plasma Protein Binding
Little or no hepatic metabolism.c
In patients with Clcr 15–35 mL/minute per 1.73 m2, plasma half-life is increased to 16–27 hours; in progressive renal impairment plasma half-life is >27 hours.c
Hemodialysis: 1–12% removed.c
Tight, light-resistant containers at 20–25°.111
Tablets (Atenolol and Chlorthalidone)
Tight, light-resistant containers at 20–25°.111
Inhibits response to adrenergic stimuli by competitively blocking β1-adrenergic receptors within the myocardium.c Blocks β2-adrenergic receptors within bronchial and vascular smooth muscle only in high doses (e.g., >100 mg daily).c
No intrinsic sympathomimetic activity and little or no membrane-stabilizing effect on the heart.c
Reduces BP by decreasing cardiac output, suppressing renin release, and/or decreasing sympathetic outflow from the CNS.c
Possibly increases oxygen requirements in patients with heart failure due to increased left ventricular fiber length and end diastolic pressure.111
Increases airway resistance (at doses >100 mg) in patients with asthma and/or COPD.c
Produces little or no changes in serum insulin concentrations, time to recovery from insulin-induced hypoglycemia, or free fatty acid response to hypoglycemia.c
Advice to Patients
Importance of taking medication exactly as prescribed.c
Importance of not interrupting or discontinuing therapy without consulting clinician.c
If a dose is missed, importance of patient taking only the next scheduled dose (i.e., the next dose should not be doubled).c
Importance of immediately informing clinician at the first sign or symptom of impending cardiac failure (e.g., weight gain, increased shortness of breath) or if any difficulty in breathing occurs.c
Importance of patients undergoing major surgery informing anesthesiologist or dentist they are receiving the drug.c
Importance of informing clinicians of existing or contemplated therapy, including prescription and OTC drugs.c
Importance of informing patient of other important precautionary information. (See Cautions.)
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
50 mg with Chlorthalidone 25 mg*
Atenolol and Chlorthalidone Tablets
100 mg with Chlorthalidone 25 mg*
Atenolol and Chlorthalidone Tablets
AHFS DI Essentials. © Copyright 2018, Selected Revisions October 30, 2017. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.
Only references cited for selected revisions after 1984 are available electronically.
101. Kraus ML, Gottlieb LD, Horwitz RI et al. Randomized clinical trial of atenolol in patients with alcohol withdrawal. N Engl J Med. 1985; 313:905-9. http://www.ncbi.nlm.nih.gov/pubmed/2863754?dopt=AbstractPlus
102. Melander A, Niklasson B, Ingemarsson I et al. Transplacental passage of atenolol in man. Eur J Clin Pharmacol. 1978; 14:93-4. http://www.ncbi.nlm.nih.gov/pubmed/720380?dopt=AbstractPlus
103. Liedholm H, Melander A, Bitzén PO et al. Accumulation of atenolol and metoprolol in human breast milk. Eur J Clin Pharmacol. 1981; 20:229-31. http://www.ncbi.nlm.nih.gov/pubmed/7286041?dopt=AbstractPlus
104. Shanahan FLJ, Counihan TB. Atenolol self-poisoning. Br Med J. 1978; 2:773. http://www.ncbi.nlm.nih.gov/pubmed/698720?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1607579&blobtype=pdf
105. Weinstein RS. Recognition and management of poisoning with beta-adrenergic blocking agents. Ann Emerg Med. 1984; 13:1123-31. http://www.ncbi.nlm.nih.gov/pubmed/6150667?dopt=AbstractPlus
106. Frishman W, Jacob H, Eisenberg E et al. Clinical pharmacology of the new beta-adrenergic blocking drugs. Part 8. Self-poisoning with beta-adrenoceptor blocking agents: recognition and management. Am Heart J. 1979; 98:798-811. http://www.ncbi.nlm.nih.gov/pubmed/40429?dopt=AbstractPlus
107. White WB, Andreoli JW, Wong SH et al. Atenolol in human plasma and breast milk. Obstet Gynecol. 1984; 63:42-4S.
108. Rubin PC, Butters L, Clark DM et al. Placebo-controlled trial of atenolol in treatment of pregnancy-associated hypertension. Lancet. 1983; 1:431-4. http://www.ncbi.nlm.nih.gov/pubmed/6131164?dopt=AbstractPlus
109. Rubin PC, Butters L, Clark D et al. Obstetric aspects of the in pregnancy-associated hypertension of the β-adrenoceptor antagonist atenolol. Am J Obstet Gynecol. 1984; 150:389-92. http://www.ncbi.nlm.nih.gov/pubmed/6385722?dopt=AbstractPlus
110. Reynolds B, Butters L, Evans J et al. First year of life after the use of atenolol in pregnancy associated hypertension. Arch Dis Child. 1984; 59:1061-3. http://www.ncbi.nlm.nih.gov/pubmed/6391390?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1628816&blobtype=pdf
111. AstraZeneca Pharmaceuticals. Tenormin (atenolol) tablets prescribing information. Wilmington, DE; 2005 Feb.
112. Stuart Pharmaceuticals. Tenormin (atenolol) product monograph—angina pectoris. Wilmington, DE; 1986 Mar.
113. First International Study of Infarct Survival Collaborative Group. Randomised trial of intravenous atenolol among 16,027 cases of suspected acute myocardial infarction: ISIS-1. Lancet. 1986; 2:57-66. http://www.ncbi.nlm.nih.gov/pubmed/2873379?dopt=AbstractPlus
114. Ratner SJ. Atenolol for alcohol withdrawal. N Engl J Med. 1986; 314:782-3. http://www.ncbi.nlm.nih.gov/pubmed/3513013?dopt=AbstractPlus
115. Carmichael D, Unwin R, Wadsworth J. Atenolol for alcohol withdrawal. N Engl J Med. 1986; 314:783.
116. Odugbesan O, Chesner IM, Bailey G et al. Hazards of combined beta-blocker/diuretic tablets. Lancet. 1985; 1:1221-2. http://www.ncbi.nlm.nih.gov/pubmed/2860426?dopt=AbstractPlus
117. Walters EG, Horswill CE, Shelton JR et al. Hazards of beta-blocker/diuretic tablets. Lancet. 1985; 2:220-1. http://www.ncbi.nlm.nih.gov/pubmed/2862406?dopt=AbstractPlus
118. AstraZeneca Pharmaceuticals. Tenoretic (atenolol and chlorthalidone) prescribing information. Wilmington, DE; 2005 Feb.
119. Abbasi IA, Sorsby S. Prolonged toxicity from atenolol overdose in an adolescent. Clin Pharm. 1986; 5:836-7. http://www.ncbi.nlm.nih.gov/pubmed/3780154?dopt=AbstractPlus
120. AstraZeneca Pharmaceuticals. Tenormin (atenolol) I.V. injection prescribing information. Wilmington, DE; 2005 Feb.
122. Yusuf S, Wittes J, Friedman L. Overview of results of randomized clinical trials in heart disease. I. Treatments following myocardial infarction. JAMA. 1988; 260:2088-93. http://www.ncbi.nlm.nih.gov/pubmed/2901501?dopt=AbstractPlus
123. ISIS-1 (First International Study of Infarct Survival) Collaborative Group. Mechanisms for the early mortality reduction produced by beta-blockade started early in acute myocardial infarction: ISIS-1. Lancet. 1988; 1:921-3. http://www.ncbi.nlm.nih.gov/pubmed/2895838?dopt=AbstractPlus
124. Yusuf S, Sleight P, Rossi P et al. Reduction in infarct size, arrhythmias and chest pain by early intravenous beta blockade in suspected acute myocardial infarction. Circulation. 1983; 67(6 Part 2):I-32-41. http://www.ncbi.nlm.nih.gov/pubmed/6851037?dopt=AbstractPlus
125. Schimmel MS, Eidelman AJ, Wilschanski MA et al. Toxic effects of atenolol consumed during breast feeding. J Pediatr. 1989; 114:476-8. http://www.ncbi.nlm.nih.gov/pubmed/2921694?dopt=AbstractPlus
126. The TIMI Study Group. Comparison of invasive and conservative strategies after treatment with intravenous tissue plasminogen activator in acute myocardial infarction: results of the thrombolysis in myocardial infarction (TIMI) phase II trial. N Engl J Med. 1989; 320:618-27. http://www.ncbi.nlm.nih.gov/pubmed/2563896?dopt=AbstractPlus
127. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Randomized trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. Lancet. 1988; 2:349-60. http://www.ncbi.nlm.nih.gov/pubmed/2899772?dopt=AbstractPlus
129. Atkinson H, Begg EJ. Concentrations of beta-blocking drugs in human milk. J Pediatr. 1990; 116:156. http://www.ncbi.nlm.nih.gov/pubmed/1967306?dopt=AbstractPlus
130. Koren G. Concentrations of beta-blocking drugs in human milk. J Pediatr. 1990; 116:156.
131. Atkinson HC, Begg EJ, Darlow BA. Drugs in human milk: clinical pharmacokinetic considerations. Clin Pharmacokinet. 1988; 14:217-40. http://www.ncbi.nlm.nih.gov/pubmed/3292101?dopt=AbstractPlus
132. American College of Cardiology and American Heart Association. ACC/AHA guidelines for the early management of patients with acute myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee to Develop Guidelines for the Early Management of Patients with Acute Myocardial Infarction). Circulation. 1990; 82:664-707. http://www.ncbi.nlm.nih.gov/pubmed/2197021?dopt=AbstractPlus
133. Buck ML, Wiest D, Gillette PC et al. Pharmacokinetics and pharmacodynamics of atenolol in children. Clin Pharmacol Ther. 1989; 46:629-33. http://www.ncbi.nlm.nih.gov/pubmed/2598566?dopt=AbstractPlus
134. Goldman L, Sia STB, Cook EF et al. Costs and effectiveness of routine therapy with long-term beta-adrenergic antagonists after acute myocardial infarction. N Engl J Med. 1988; 319:152-7. http://www.ncbi.nlm.nih.gov/pubmed/2898733?dopt=AbstractPlus
135. Yusuf S, Peto R, Lewis J et al. Beta blockade during and after myocardial infarction: an overview of the randomized trials. Prog Cardiovasc Dis. 1985; 27:335-71. http://www.ncbi.nlm.nih.gov/pubmed/2858114?dopt=AbstractPlus
136. Yusuf S, Sleight P, Held P et al. Routine medical management of acute myocardial infarction: lessons from overviews of recent randomized controlled trials. Circulation. 1990; 82(Suppl 11):11-117-34.
137. Held P, Yusuf S. Early intravenous beta-blockade in acute myocardial infarction. Cardiology. 1989; 76:132-43. http://www.ncbi.nlm.nih.gov/pubmed/2568179?dopt=AbstractPlus
138. Pedersen TR for the Norwegian Multicenter Study Group. Six-year follow-up of the Norwegian multicenter study on timolol after acute myocardial infarction. N Engl J Med. 1985; 313:1055-8. http://www.ncbi.nlm.nih.gov/pubmed/2864634?dopt=AbstractPlus
139. Pedersen TR for the Norwegian Multicenter Study Group. The Norwegian multicenter study of timolol after myocardial infarction. Circulation. 1983; 67(Suppl 1):49-53.
140. The Beta-Blocker Pooling Project Research Group. The Beta-Blocker Pooling Project (BBPP): subgroup findings from randomized trials in post infarction patients. Eur Heart J. 1988; 9:8-16.
141. β-Blocker Heart Attack Trial Research Group. A randomized trial of propranolol in patients with acute myocardial infarction: I. Mortality results. JAMA. 1982; 247:1707-14. http://www.ncbi.nlm.nih.gov/pubmed/7038157?dopt=AbstractPlus
142. The Norwegian Multicenter Study Group. Timolol-induced reduction in mortality and reinfarction in patients surviving acute myocardial infarction. N Engl J Med. 1981; 304(Suppl 14):801-7. http://www.ncbi.nlm.nih.gov/pubmed/7010157?dopt=AbstractPlus
143. Gheorghiade M, Schultz L, Tilley B et al. Effects of propranolol in non-Q-wave acute myocardial infarction in the beta blocker heart attack trial. Am J Cardiol. 1990; 66:129-33. http://www.ncbi.nlm.nih.gov/pubmed/2196771?dopt=AbstractPlus
144. Yusuf S, Wittes J, Probstfield J. Evaluating effects of treatment in subgroups of patients with a clinical trial: the case of non-Q-wave myocardial infarction and beta blockers. Am J Cardiol. 1990; 66:220-2. http://www.ncbi.nlm.nih.gov/pubmed/1973589?dopt=AbstractPlus
145. Griggs TR, Wagner GS, Gettes LS. Beta-adrenergic blocking agents after myocardial infarction: an undocumented need in patients at lowest risk. J Am Coll Cardiol. 1983; 1:1530-3. http://www.ncbi.nlm.nih.gov/pubmed/6133891?dopt=AbstractPlus
146. Pedersen TR for the Norwegian Multicenter Study Group. Six-year follow-up of the Norwegian multicenter study on timolol after myocardial infarction. N Engl J Med. 1986; 314:1052.
147. Frishman WH, Furberg CD, Friedewald WT. β-Adrenergic blockade for survivors of acute myocardial infarction. N Engl J Med. 1984; 310:830-7. http://www.ncbi.nlm.nih.gov/pubmed/6142420?dopt=AbstractPlus
148. Roque F, Amuchastegui LM, Lopez Morillos MA et al. The TIARA Study Group: beneficial effects of timolol on infarct size and late ventricular tachycardia in patients with acute myocardial infarction. Circulation. 1987; 76:610-7. http://www.ncbi.nlm.nih.gov/pubmed/3304706?dopt=AbstractPlus
149. Roberts R, Rogers WJ, Mueller H et al. Immediate versus deferred β-blockade following thrombolytic therapy in patients with acute myocardial infarction, results of the Thrombolysis in Myocardial Infarction (TIMI) II-B study. Circulation. 1991; 83:422-37. http://www.ncbi.nlm.nih.gov/pubmed/1671346?dopt=AbstractPlus
151. Geneva. Atenolol tablets prescribing information. Broomfield, CO; 1991 Oct.
153. Weber MA, Laragh JH. Hypertension: steps forward and steps backward: the Joint National Committee fifth report. Arch Intern Med. 1993; 153:149-52. http://www.ncbi.nlm.nih.gov/pubmed/8422205?dopt=AbstractPlus
154. Collins R, Peto R, MacMahon S et al. Blood pressure, stroke, and coronary heart disease. Part 2, short-term reductions in blood pressure: an overview of randomized drug trials in their epidemiological context. Lancet. 1990; 335:827-38. http://www.ncbi.nlm.nih.gov/pubmed/1969567?dopt=AbstractPlus
155. Alderman MH. Which antihypertensive drugs first—and why! JAMA. 1992; 267:2786-7. Editorial.
156. MacMahon S, Peto R, Cutler J et al. Blood pressure, stroke, and coronary heart disease. Part 1, prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet. 1990; 335:765-74. http://www.ncbi.nlm.nih.gov/pubmed/1969518?dopt=AbstractPlus
157. SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension: final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA. 1991; 265:3255-64. http://www.ncbi.nlm.nih.gov/pubmed/2046107?dopt=AbstractPlus
158. Dahlof B, Lindholm LH, Hansson L et al. Morbidity and mortality in the Swedish Trial in Old Patients with Hypertension (STOP-hypertension). Lancet. 1991; 338:1281-5. http://www.ncbi.nlm.nih.gov/pubmed/1682683?dopt=AbstractPlus
159. MRC Working Party. Medical Research Council trial of treatment of hypertension in older adults: principal results. BMJ. 1992; 304:405-12. http://www.ncbi.nlm.nih.gov/pubmed/1445513?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1995577&blobtype=pdf
160. National Heart, Lung, and Blood Institute. NHLBI panel reviews safety of calcium channel blockers. Rockville, MD; 1995 Aug 31. Press release.
161. National Heart, Lung, and Blood Institute. New analysis regarding the safety of calcium-channel blockers: a statement for health professionals from the National Heart, Lung, and Blood Institute. Rockville, MD; 1995 Sep 1.
162. Psaty BM, Heckbert SR, Koepsell TD et al. The risk of myocardial infarction associated with antihypertensive drug therapies. JAMA. 1995; 274:620-5. http://www.ncbi.nlm.nih.gov/pubmed/7637142?dopt=AbstractPlus
163. Yusuf S. Calcium antagonists in coronary artery disease and hypertension: time for reevaluation? Circulation. 1995; 92:1079-82. Editorial.
164. Butters L, Kennedy S, Rubin PC. Atenolol in essential hypertension during pregnancy. Br Med J. 1990; 301:587-9.
165. Sibai BM. Treatment of hypertension in pregnant women. N Engl J Med. 1996; 335:257-65. http://www.ncbi.nlm.nih.gov/pubmed/8657243?dopt=AbstractPlus
167. Roche. Posicor (mibefradil hydrochloride) tablets prescribing information. Nutley, NJ; 1997 Dec.
168. Ellison RH. Dear doctor letter regarding appropriate use of Posicor. Nutley, NJ: Roche Laboratories; 1997 Dec.
171. Kaplan NM. Choice of initial therapy for hypertension. JAMA. 1996; 275:1577-80. http://www.ncbi.nlm.nih.gov/pubmed/8622249?dopt=AbstractPlus
172. Psaty BM, Smith NL, Siscovich DS et al. Health outcomes associated with antihypertensive therapies used as first-line agents: a systematic review and meta-analysis. JAMA. 1997; 277:739-45. http://www.ncbi.nlm.nih.gov/pubmed/9042847?dopt=AbstractPlus
173. Whelton PK, Appel LJ, Espeland MA et al. for the TONE Collaborative Research Group. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). JAMA. 1998; 279:839-46. http://www.ncbi.nlm.nih.gov/pubmed/9515998?dopt=AbstractPlus
175. Genuth S. United Kingdom prospective diabetes study results are in. J Fam Pract. 1998; 47:(Suppl 5):S27.
177. Watkins PJ. UKPDS: a message of hope and a need for change. Diabet Med. 1998; 15:895-6. http://www.ncbi.nlm.nih.gov/pubmed/9827842?dopt=AbstractPlus
178. Bretzel RG, Voit K, Schatz H et al. The United Kingdom Prospective Diabetes Study (UKPDS): implications for the pharmacotherapy of type 2 diabetes mellitus. Exp Clin Endocrinol Diabetes. 1998; 106:369-72. http://www.ncbi.nlm.nih.gov/pubmed/9831300?dopt=AbstractPlus
179. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998; 317:703-13. http://www.ncbi.nlm.nih.gov/pubmed/9732337?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=28659&blobtype=pdf
180. American Diabetes Association. The United Kingdom Prospective Diabetes Study (UKPDS) for type 2 diabetes: what you need to know about the results of a long-term study. Washington, DC; 1998 Sep 15 from American Diabetes Association web site. http://www.diabetes.org
181. UK Prospective Diabetes Study Group. Efficacy of atenolol and captopril in reducing risk of macrovascular complications in type 2 diabetes: UKPDS 39. BMJ. 1998; 317:713-20. http://www.ncbi.nlm.nih.gov/pubmed/9732338?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=28660&blobtype=pdf
182. Davis TM. United Kingdom Prospective Diabetes Study: the end of the beginning? Med J Aust. 1998; 169:511-2.
183. American Diabetes Association. Clinical Practice Recommendations 1999. Position statement. Implications of the United Kingdom propective Diabetes Study. Diabetes Care. 1999; 22(Suppl 1):S27-31.
184. Tenormin (atenolol) tablets and injection and Tenoretice (atenolol/chlorthalidone) tablets. In: MedWatch: summary of safety-related drug labeling changes approved by FDA. Rockville, MD: US Food and Drug Administration; 1999 Jul.
185. Anon. Consensus recommendations for the management of chronic heart failure. On behalf of the membership of the advisory council to improve outcomes nationwide in heart failure. Part II. Management of heart failure: apporaches to the prevention of heart failure. Am J Cardiol. 1999; 83:9A-38A.
186. Packer M, Colucci WS, Sackner-Bernstein JD et al et al. Double-blind, placebo-controlled study of the effects of carvedilol in patients with moderate to severe heart failure: the PRECISE trial. Circulation. 1996; 94:2793-9. http://www.ncbi.nlm.nih.gov/pubmed/8941104?dopt=AbstractPlus
187. Fisher ML, Gottlieb SS, Plotnick GD et al. Beneficial effects of metoprolol in heart failure associated with coronary artery disease: a randomized trial. J Am Coll Cardiol. 1994; 23:943-50. http://www.ncbi.nlm.nih.gov/pubmed/8106700?dopt=AbstractPlus
188. Bristow MR, Gilbert EM, Abraham WT et al et al. Carvedilol produces dose-related improvements in left ventricular function and survival in subjects with chronic heart failure. Circulation. 1996; 94:2807-16. http://www.ncbi.nlm.nih.gov/pubmed/8941106?dopt=AbstractPlus
189. Metra M, Nardi M, Raffaele G et al. Effects of short- and long-term carvedilol administration on rest and exercise hemodynamic variables, exercise capacity and clinical conditions in patients with idiopathic dilated cardiomyopathy. J Am Coll Cardiol. 1994; 24:1678-87. http://www.ncbi.nlm.nih.gov/pubmed/7963115?dopt=AbstractPlus
190. Olsen SL, Gilbert EM, renlund DG et al. Carvedilol improves left ventricular function and symptoms in chronic heart failure: a double-blind randomized study. J Am Coll Cardiol. 1995; 25:1225-31. http://www.ncbi.nlm.nih.gov/pubmed/7722114?dopt=AbstractPlus
191. Krum H, Sackner-Bernstein JD, Goldsmith RL et al. Double-blind placebo controlled study of the long-term efficacy of carvedilol in patients with severe chronic heart failure. Circulation. 1995; 92:1499-506. http://www.ncbi.nlm.nih.gov/pubmed/7664433?dopt=AbstractPlus
192. Waagstein F, Bristow MR, Swedberg K et al. Beneficial effects of metoprolol in idiopathic dilated cardiomyopathy. Lancet. 1993; 342:1441-6. http://www.ncbi.nlm.nih.gov/pubmed/7902479?dopt=AbstractPlus
193. CIBIS Investigators and Committees. A randomized trial of β-blockade in heart failure: the cardiac insufficiency bisoprolol study (CIBIS). Circulation. 1994; 90:1765-73. http://www.ncbi.nlm.nih.gov/pubmed/7923660?dopt=AbstractPlus
194. Colucci WS, Packer M, Bristow MR et al et al. Carvedilol inhibits clinical progression in patients with mild symptoms of heart failure. Circulation. 1996; 94:2800-6. http://www.ncbi.nlm.nih.gov/pubmed/8941105?dopt=AbstractPlus
195. MERIT-HF Study Group. Effect of metoprolol CR/XL in chronic heart failure: metoprolol CR/XL Randomized Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet. 1999; 353:2001-7. http://www.ncbi.nlm.nih.gov/pubmed/10376614?dopt=AbstractPlus
196. Bristow MR, Gilbert EM, Abraham WT et al. Effect of carvedilol on LV function and mortality in diabetic versus non-diabetic patients with ischemic or nonischemic dilated cardimyopathy. Circulation. 1996; 94(Suppl I):I664.
197. Lechat P, Packer M, Chalon S et al. Clinical effects of β-adrenergic blockade in chronic heart failure: a meta-analysis of double-blind, placebo-controlled, randomized trials. Circulation. 1998; 98:1184-91. http://www.ncbi.nlm.nih.gov/pubmed/9743509?dopt=AbstractPlus
198. Van Campen LC, Visser FC, Visser CA. Ejection fraction improvement by beta-blocker treatment in patients with heart failure: an analysis of studies published in the literature. J Cardiovasc Pharmacol. 1998; 32(Suppl 1):S31-5. http://www.ncbi.nlm.nih.gov/pubmed/9731693?dopt=AbstractPlus
199. SmithKline Beecham Pharmaceuticals. Coreg (carvedilol) tablets prescribing information. Philadelphia, PA; 1998 May.
200. Rousseau MF, Chapelle F, Van Eyll C et al. Medium-term effects of beta-blockade on left ventricular mechanics: a double-blind, placebo-controlled comparison of nebivolol and atenolol in patients with ischemic left ventricular dysfunction. J Card Fail. 1996; 2:15-23. http://www.ncbi.nlm.nih.gov/pubmed/8798100?dopt=AbstractPlus
201. Mattioli AV, Modena MG, Fantini G et al. Atenolol in dilated cardiomyopathy: a clinical instrumental study. Cardiovasc Drugs Ther. 1990; 4:505-7 prevention of heart failure. http://www.ncbi.nlm.nih.gov/pubmed/2285633?dopt=AbstractPlus
202. The United States pharmacopeia, 24th rev, and The national formulary, 19th ed. Rockville, MD: The United States Pharmacopeial Convention, Inc; 2000:176.
203. Tenormin (atenolol) tablets and injection and Tenoretice (atenolol/chlorthalidone) tablets. In: MedWatch: summary of safety-related drug labeling changes approved by FDA. Rockville, MD: US Food and Drug Administration; 1999 Jul.
204. Lim PO, MacDonald TM. Antianginal and β-adrenergic blocking drugs. In: Dukes MNG, ed. Meyler’s side effects of drugs. 13th ed. New York: Elsevier/North Holland Inc; 1996:488-535.
205. Gress TW, Nieto FJ, Shahar E et al. Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. N Engl J Med. 2000; 342:905-12. http://www.ncbi.nlm.nih.gov/pubmed/10738048?dopt=AbstractPlus
206. Sowers JR, Bakris GL. Antihypertensive therapy and the risk of type 2 diabetes mellitus. N Engl J Med. 2000; 342:969-70. http://www.ncbi.nlm.nih.gov/pubmed/10738057?dopt=AbstractPlus
207. Izzo JL, Levy D, Black HR. Importance of systolic blood pressure in older Americans. Hypertension. 2000; 35:1021-4. http://www.ncbi.nlm.nih.gov/pubmed/10818056?dopt=AbstractPlus
208. Frohlich ED. Recognition of systolic hypertension for hypertension. Hypertension. 2000; 35:1019-20. http://www.ncbi.nlm.nih.gov/pubmed/10818055?dopt=AbstractPlus
209. Bakris GL, Williams M, Dworkin L et al. Preserving renal function in adults with hypertension and diabetes: a consensus approach. Am J Kidney Dis. 2000; 36:646-61. http://www.ncbi.nlm.nih.gov/pubmed/10977801?dopt=AbstractPlus
210. Hansson L, Zanchetti A, Carruthers SG et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. Lancet. 1998; 351:1755-62. http://www.ncbi.nlm.nih.gov/pubmed/9635947?dopt=AbstractPlus
212. Scher DL, Arsura EL. Multifocal atrial tachycardia: mechanisms, clinical correlates, and treatment. Am Heart J. 1989; 118:574-80. http://www.ncbi.nlm.nih.gov/pubmed/2570520?dopt=AbstractPlus
213. Lui CY, Franchina JJ. Verapamil and multifocal atrial tachycardia. Ann Intern Med. 1988; 108:485-6.
216. ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Chronic Stable Angina). J Am Coll Cardiol. 1999; 33:2092-7.
218. Fuster V, Ryden LE, Asinger RW et al. ACC/AHA/ESC guidelines for the management of atrial fibrillation. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients with Atrial Fibrillation). J Am Coll Cardiol. 2001; 38:1266i-lxx.
219. Califf RM, O’Connor CM. β-Blocker therapy for heart failure. The evidence is in, now the work begins. JAMA. 2000; 283:1335-6. http://www.ncbi.nlm.nih.gov/pubmed/10714735?dopt=AbstractPlus
220. Hunt SA, Baker DW, Chin MH et al. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure). 2001. From ACC website. Accessed July 25, 2002. http://www.cardiosource.org/Science-And-Quality/Practice-Guidelines-and-Quality-Standards.aspx
221. Hjalmarson A, Goldstein S, Fagerberg B et al. Effects of controlled-release metoprolol on total mortality, hospitalizations, and well-being in patients with heart failure: the Metoprolol CR/XL Randomized Intervention Trial in Congestive Heart Failure (MERIT-HF). JAMA. 2000; 283:1295-1302. http://www.ncbi.nlm.nih.gov/pubmed/10714728?dopt=AbstractPlus
222. Williams CL, Hayman LL, Daniels SR et al. Cardiovascular health in childhood: a statement for health professional from the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. 2002; 106:143-60. http://www.ncbi.nlm.nih.gov/pubmed/12093785?dopt=AbstractPlus
225. American Heart Association in collaboration with the International Liaison Committee on Resuscitation. Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care. Part 7: the era of reperfusion. Circulation. 2000;102(Suppl I):I172-I203.
226. Appel LJ. The verdict from ALLHAT—thiazide diuretics are the preferred initial therapy for hypertension. JAMA. 2002; 288:3039-60. http://www.ncbi.nlm.nih.gov/pubmed/12479770?dopt=AbstractPlus
227. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002; 288:2981-97. http://www.ncbi.nlm.nih.gov/pubmed/12479763?dopt=AbstractPlus
228. US Headache Consortium. Evidence-based guidelines for migraine headache in the primary care setting: pharmacological management for prevention of migraine. St. Paul, Minnesota; December 10, 2001. From the American Academy of Neurology website. http://www.aan.com
229. Saitz R. Introduction to alcohol withdrawal. Alcohol Health Res World. 1998; 22:5-12. http://www.ncbi.nlm.nih.gov/pubmed/15706727?dopt=AbstractPlus
230. American Society of Addiction Medicine. Pharmacological management of alcohol withdrawal: a meta-analysis and evidence-based practice guideline. JAMA. 1997; 278:144-51. http://www.ncbi.nlm.nih.gov/pubmed/9214531?dopt=AbstractPlus
232. Douglas JG, Bakris GL, Epstein M et al. Management of high blood pressure in African Americans: Consensus statement of the Hypertension in African Americans Working Group of the International Society on Hypertension in Blacks. Arch Intern Med. 2003; 163:525-41.
234. The Guidelines Subcommitee of the WHO/ISH Mild Hypertension Liaison Committee. 1999 guidelines for the management of hypertension. J Hypertension. 1999; 17:392-403.
235. Neal B, MacMahon S, Chapman N. Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs. Lancet. 2000;356:1955-64.
236. Black HR, Elliott WJ, Grandits G, et al. Principal results of the Controlled Onset Verapamil Investigation of Cardiovascular End Points (CONVINCE) trial. JAMA. 2003;289:2073-2082.
237. Dahlof B, Devereux RB, Kjeldsen SE, et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint Reduction in Hypertension Study (LIFE). Lancet. 2002;359:995-1003.
238. The Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med. 2000;342:145-153.
239. PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. Lancet. 2001;358:1033-41.
240. Wing LMH, Reid CM, Ryan P, et al, for Second Australian National Blood Pressure Study Group. A comparison of outcomes with angiotensin-converting-enzyme inhibitors and diuretics for hypertension in the elderly. N Engl J Med. 2003;348:583-92.
242. Kaplan NM. Initial treatment of adult patients with essential hypertension. Part 2: alternating monotherapy is the preferred treatment. Pharmacotherapy. 1985; 5:195-200. http://www.ncbi.nlm.nih.gov/pubmed/4034407?dopt=AbstractPlus
243. Bauer JH. Stepped-care approach to the treatment of hypertension: is it obsolete? (unpublished observations)
244. Cushman WC, Ford CE, Cutler JA, et al. Success and predictors of blood pressure control in diverse North American settings: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). J Clin Hypertens (Greenwich). 2002;4:393-404.
245. Black HR, Elliott WJ, Neaton JD et al. Baseline characteristics and elderly blood pressure control in the CONVINCE trial. Hypertension. 2001; 37:12-18. http://www.ncbi.nlm.nih.gov/pubmed/11208750?dopt=AbstractPlus
246. Packer M, Coats AJ, Fowler MB, et al. Effect of carvedilol on survival in severe chronic heart failure. N Engl J Med. 2001;344:1651-58.
247. The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med. 1991;325:293-302.
248. The Acute Infarction Ramipril Efficacy (AIRE) Study Investigators. Effect of ramipril on mortality and morbidity of survivors of acute myocardial infarction with clinical evidence of heart failure. Lancet. 1993; 342:821-8. http://www.ncbi.nlm.nih.gov/pubmed/8104270?dopt=AbstractPlus
249. Kober L, Torp-Pedersen C, Carlsen JE, et al, for Trandolapril Cardiac Evaluation (TRACE) Study Group. A clinical trial of the angiotensin-converting-enzyme inhibitor trandolapril in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 1995;333:1670-6.
250. Hager WD, Davis BR, Riba A, et al, for the Survival and Ventricular Enlargement (SAVE) Investigators. Absence of a deleterious effect of calcium channel blockers in patients with left ventricular dysfunction after myocardial infarction: the SAVE Study Experience. Am Heart J. 1998;135:406-13.
251. Pitt B, Remme W, Zannad F, et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 2003;348:1309-1321.
252. Tepper D. Frontiers in congestive heart failure: effect of metoprolol CR/XL in chronic heart failure: MetoprololCR/XL Randomized Intervention Trial in Congestive Heart Failure (MERIT-HF). Congest Heart Fail. 1999;5:184-5.
253. The Capricorn Investigators. Effect of carvedilol on outcome after myocardial infarction in patients with left-ventricular dysfunction: the Capricorn randomized trial. Lancet. 2001; 357:1385-90. http://www.ncbi.nlm.nih.gov/pubmed/11356434?dopt=AbstractPlus
254. Pfeffer MA, Braunwald E, Moye LA et al for the SAVE Investigators Group. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction: results of the Survival and Ventricular Enlargment Trial. N Engl J Med. 1992; 327:669. http://www.ncbi.nlm.nih.gov/pubmed/1386652?dopt=AbstractPlus
255. Cohn JN, Tognoni GA. A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure. N Engl J Med. 2001; 345:1667-75. http://www.ncbi.nlm.nih.gov/pubmed/11759645?dopt=AbstractPlus
256. Pitt B, Zannad F, Remme WJ et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med. 1999; 341:709-17. http://www.ncbi.nlm.nih.gov/pubmed/10471456?dopt=AbstractPlus
257. Reviewers’ comments (personal observations) on the Thiazides General Statement 40:28.
258. National high blood pressure education program working group on hypertension control in children and adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004; 114(Suppl 2):555-76.
259. Wright JT, Dunn JK, Cutler JA et al. Outcomes in hypertensive black and nonblack patients treated with chlorthalidone, amlodipine, and lisinopril. JAMA. 2005; 293:1595-607. http://www.ncbi.nlm.nih.gov/pubmed/15811979?dopt=AbstractPlus
260. Neaton JD, Kuller LH. Diuretics are color blind. JAMA. 2005; 293:1663-6. http://www.ncbi.nlm.nih.gov/pubmed/15811986?dopt=AbstractPlus
262. Thadani U. Beta blockers in hypertension. Am J Cardiol. 1983; 52:10-5D.
263. Conolly ME, Kersting F, Dollery CT. The clinical pharmacology of beta-adrenoceptor-blocking drugs. Prog Cardiovasc Dis. 1976; 19:203-34. http://www.ncbi.nlm.nih.gov/pubmed/10600?dopt=AbstractPlus
264. Shand DG. State-of-the-art: comparative pharmacology of the β-adrenoceptor blocking drugs. Drugs. 1983; 25(Suppl 2):92-9.
265. Breckenridge A. Which beta blocker? Br Med J. 1983; 286:1085-8. (IDIS 169422)
266. Anon. Choice of a beta-blocker. Med Lett Drugs Ther. 1986; 28:20-2. http://www.ncbi.nlm.nih.gov/pubmed/2869400?dopt=AbstractPlus
267. Wallin JD, Shah SV. β-Adrenergic blocking agents in the treatment of hypertension: choices based on pharmacological properties and patient characteristics. Arch Intern Med. 1987; 147:654-9. http://www.ncbi.nlm.nih.gov/pubmed/2881524?dopt=AbstractPlus
268. McDevitt DG. β-Adrenoceptor blocking drugs and partial agonist activity: is it clinically relevant? Drugs. 1983; 25:331-8.
269. McDevitt DG. Clinical significance of cardioselectivity: state-of-the-art. Drugs. 1983; 25(Suppl 2):219-26.
270. Frishman WH. β-Adrenoceptor antagonists: new drugs and new indications. N Engl J Med. 1981; 305:500-6. http://www.ncbi.nlm.nih.gov/pubmed/6114433?dopt=AbstractPlus
271. Thadani U, Davidson C, Chir B et al. Comparison of the immediate effects of five β-adrenoceptor-blocking drugs with different ancillary properties in angina pectoris. N Engl J Med. 1979; 300:750-5. http://www.ncbi.nlm.nih.gov/pubmed/581782?dopt=AbstractPlus
272. Lewis RV, McDevitt DG. Adverse reactions and interactions with β-adrenoceptor blocking drugs. Med Toxicol. 1986; 1:343-61. http://www.ncbi.nlm.nih.gov/pubmed/2878346?dopt=AbstractPlus
273. Frishman WH. Clinical differences between beta-adrenergic blocking agents: implications for therapeutic substitution. Am Heart J. 1987; 113:1190-8. http://www.ncbi.nlm.nih.gov/pubmed/2883867?dopt=AbstractPlus
274. The American Heart Association. Guidelines 2005 for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2005; 112(Suppl I): IV1-211.
300. Page RL, Joglar JA, Caldwell MA et al. 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2016; 67:e27-e115.
301. January CT, Wann LS, Alpert JS et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014; 64:e1-76. http://www.ncbi.nlm.nih.gov/pubmed/24685669?dopt=AbstractPlus
400. Link MS, Berkow LC, Kudenchuk PJ et al. Part 7: Adult Advanced Cardiovascular Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015; 132(18 Suppl 2):S444-64. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=4771073&blobtype=pdf
401. Neumar RW, Otto CW, Link MS et al. Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010; 122(18 Suppl 3):S729-67.
500. National Heart, Lung, and Blood Institute National High Blood Pressure Education Program. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). Bethesda, MD: National Institutes of Health; 2004 Aug. (NIH publication No. 04-5230.)
501. James PA, Oparil S, Carter BL et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014; 311:507-20. http://www.ncbi.nlm.nih.gov/pubmed/24352797?dopt=AbstractPlus
502. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013; 31:1281-357. http://www.ncbi.nlm.nih.gov/pubmed/23817082?dopt=AbstractPlus
503. Go AS, Bauman MA, Coleman King SM et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. 2014; 63:878-85. http://www.ncbi.nlm.nih.gov/pubmed/24243703?dopt=AbstractPlus
504. Weber MA, Schiffrin EL, White WB et al. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich). 2014; 16:14-26. http://www.ncbi.nlm.nih.gov/pubmed/24341872?dopt=AbstractPlus
505. Wright JT, Fine LJ, Lackland DT et al. Evidence supporting a systolic blood pressure goal of less than 150 mm Hg in patients aged 60 years or older: the minority view. Ann Intern Med. 2014; 160:499-503. http://www.ncbi.nlm.nih.gov/pubmed/24424788?dopt=AbstractPlus
506. Mitka M. Groups spar over new hypertension guidelines. JAMA. 2014; 311:663-4. http://www.ncbi.nlm.nih.gov/pubmed/24549531?dopt=AbstractPlus
507. Peterson ED, Gaziano JM, Greenland P. Recommendations for treating hypertension: what are the right goals and purposes?. JAMA. 2014; 311:474-6. http://www.ncbi.nlm.nih.gov/pubmed/24352710?dopt=AbstractPlus
508. Bauchner H, Fontanarosa PB, Golub RM. Updated guidelines for management of high blood pressure: recommendations, review, and responsibility. JAMA. 2014; 311:477-8. http://www.ncbi.nlm.nih.gov/pubmed/24352759?dopt=AbstractPlus
511. JATOS Study Group. Principal results of the Japanese trial to assess optimal systolic blood pressure in elderly hypertensive patients (JATOS). Hypertens Res. 2008; 31:2115-27. http://www.ncbi.nlm.nih.gov/pubmed/19139601?dopt=AbstractPlus
515. Thomas G, Shishehbor M, Brill D et al. New hypertension guidelines: one size fits most?. Cleve Clin J Med. 2014; 81:178-88. http://www.ncbi.nlm.nih.gov/pubmed/24591473?dopt=AbstractPlus
516. Wright JT, Bakris G, Greene T et al. Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. JAMA. 2002; 288:2421-31. http://www.ncbi.nlm.nih.gov/pubmed/12435255?dopt=AbstractPlus
520. American Diabetes Association. Standards of medical care in diabetes--2014. Diabetes Care. 2014; 37 Suppl 1:S14-80.
523. Fihn SD, Gardin JM, Abrams J et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012; 126:e354-471.
524. WRITING COMMITTEE MEMBERS, Yancy CW, Jessup M et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013; 128:e240-327.
525. Smith SC, Benjamin EJ, Bonow RO et al. AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and other Atherosclerotic Vascular Disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation. Circulation. 2011; 124:2458-73. http://www.ncbi.nlm.nih.gov/pubmed/22052934?dopt=AbstractPlus
526. Kernan WN, Ovbiagele B, Black HR et al. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2014; :. http://www.ncbi.nlm.nih.gov/pubmed/24788967?dopt=AbstractPlus
527. O'Gara PT, Kushner FG, Ascheim DD et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013; 127:e362-425. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=3695607&blobtype=pdf
530. Myers MG, Tobe SW. A Canadian perspective on the Eighth Joint National Committee (JNC 8) hypertension guidelines. J Clin Hypertens (Greenwich). 2014; 16:246-8. http://www.ncbi.nlm.nih.gov/pubmed/24641124?dopt=AbstractPlus
535. Taler SJ, Agarwal R, Bakris GL et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for management of blood pressure in CKD. Am J Kidney Dis. 2013; 62:201-13. http://www.ncbi.nlm.nih.gov/pubmed/23684145?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=3929429&blobtype=pdf
536. Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int Suppl. 2012: 2: 337-414.
541. Perk J, De Backer G, Gohlke H et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J. 2012; 33:1635-701. http://www.ncbi.nlm.nih.gov/pubmed/22555213?dopt=AbstractPlus
600. AstraZeneca. Tenormin (atenolol) tablets prescribing information. Wilmington, DE; 2012 Oct.
800. Yancy CW, Jessup M, Bozkurt B et al. 2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure: An Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. 2016; :. http://circ.ahajournals.org/content/134/13/e282.long
801. Chen ZM, Pan HC, Chen YP et al. Early intravenous then oral metoprolol in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet. 2005; 366:1622-32. http://www.ncbi.nlm.nih.gov/pubmed/16271643?dopt=AbstractPlus
802. Bockstall K, Bangalore S. How long should we continue beta-blockers after MI? 2017 Jan 23. From ACC website. Accessed 2017 May 17. http://www.acc.org/latest-in-cardiology/articles/2017/01/20/09/36/how-long-should-we-continue-beta-blockers-after-mi
803. Lamas GA, Escolar E, Faxon DP. Examining treatment of ST-elevation myocardial infarction: the importance of early intervention. J Cardiovasc Pharmacol Ther. 2010; 15:6-16. http://www.ncbi.nlm.nih.gov/pubmed/20061507?dopt=AbstractPlus
804. Kezerashvili A, Marzo K, De Leon J. Beta blocker use after acute myocardial infarction in the patient with normal systolic function: when is it “ok” to discontinue?. Curr Cardiol Rev. 2012; 8:77-84. http://www.ncbi.nlm.nih.gov/pubmed/22845818?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=3394111&blobtype=pdf
805. Reed GW, Rossi JE, Cannon CP. Acute myocardial infarction. Lancet. 2017; 389:197-210. http://www.ncbi.nlm.nih.gov/pubmed/27502078?dopt=AbstractPlus
806. Freemantle N, Cleland J, Young P et al. beta Blockade after myocardial infarction: systematic review and meta regression analysis. BMJ. 1999; 318:1730-7. http://www.ncbi.nlm.nih.gov/pubmed/10381708?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=31101&blobtype=pdf
807. Smith JN, Negrelli JM, Manek MB et al. Diagnosis and management of acute coronary syndrome: an evidence-based update. J Am Board Fam Med. 2015 Mar-Apr; 28:283-93.
808. Anderson JL, Morrow DA. Acute Myocardial Infarction. N Engl J Med. 2017; 376:2053-2064. http://www.ncbi.nlm.nih.gov/pubmed/28538121?dopt=AbstractPlus
1100. Amsterdam EA, Wenger NK, Brindis RG et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014; 130:e344-426. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=4676081&blobtype=pdf
1101. Fihn SD, Gardin JM, Abrams J et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012; 126:e354-471.
c. AHFS Drug Information 2018. McEvoy GK, ed. Atenolol. Bethesda, MD: American Society of Health-System Pharmacists; 2018:.
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