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Scots GPs refuse to fine non-attenders

A widely prescribed ?-blocker may not prevent cardiac events or death, suggests controversial new research .

The Swedish systematic review casts doubt on GPs' use of atenolol to treat hypertensive patients, despite the significant blood pressure-lowering effect of the drug.

The review of nine studies found that atenolol was no more effective than placebo

in reducing overall mortality, nor cardiovascular events and deaths.

Cardiovascular mortality and stroke incidence was also higher in patients taking atenolol than those on other antihypertensive therapy, (relative risk 1.16 and 1.30 respectively).

The researchers said their findings 'cast doubts on atenolol as a suitable first-line drug for hypertensive patients' and expressed concern that atenolol was often used as a reference drug in trials of antihypertensive medication.

Four placebo-controlled trials comprising 6,825 patients, and five trials versus other drugs comprising 17,671 patients, were analysed in the research published in The Lancet (November 6).

?-blockers, including atenolol, are indicated as a first- line treatment under British Hypertension Society guidelines and are recommended by NICE as an alternative first-line treatment if diuretics are not tolerated.

But questions were raised last year about ?-blockers as first-line treatment in hypertension, and in the LIFE trial losartan was shown to be more effective than atenolol in hypertensive patients with left ventricular hypertrophy.

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