An investigation of the impact of atenolol on the risk of all-cause mortality in Asian individuals with hypertension and cardiovascular conditions

Abstract

Background Despite several justifications for utilizing beta-blockers, such as atenolol, as the initial treatment for hypertension in the presence of cardiovascular disease, some studies have demonstrated that calcium channel blockers were more effective than beta-blockers in decreasing mortality. This review intended to determine the efficacy of atenolol in reducing all-cause mortality in Asian individuals with hypertension, coronary artery disease, atrial fibrillation, and heart failure. Main body of the abstract Studies published before March 31, 2023, were searched using Trip, Google Scholar, Cochrane, and EMBASE databases. We only considered studies that compared atenolol with other medications in terms of all-cause mortality rates in Asian individuals diagnosed with hypertension and cardiovascular diseases. Therefore, we only considered three trials with a total of 79,603 participants. The results indicated a statistically significant higher all-cause death rate among non-atenolol users compared to atenolol users (p < 0.001). The all-cause death rate was considerably greater in individuals who consumed metoprolol tartrate compared to those who consumed atenolol (OR = 0.50, p < 0.0001). Although the included publications were deemed to have a low risk of bias, significant heterogeneity was observed (p = 0.001). Short conclusion Due to the limited studies included, this analysis concluded that atenolol, in comparison with non-users of atenolol or especially metoprolol tartrate, significantly reduces the overall death rate in East Asian and Southeast Asian patients with hypertension, coronary artery disease, atrial fibrillation, and heart failure. Yet, the current study cannot finalize this conclusion for other Asian ethnic groups, such as South Asians, Central Asians, and West Asians. Additional systematic reviews and meta-analyses with low heterogeneity and high-quality evidence are suggested to validate our findings and explore the efficacy of atenolol in various ethnic populations.