Atenolol Atherosclerosis

The peculiar vascular protective and anti-atherosclerotic properties of lacidipine were further confirmed in the European Lacidipine Study on Atherosclerosis (ELSA), where the carotid atherosclerotic process was slowed down by lacidipine in comparison with atenolol [19]. 

Intermittent claudication has also been reported to be worsened by beta-adrenoceptor antagonists, but has been difficult to document because of the difficulty of study design in patients with advanced atherosclerosis. As early as 1975 it was reported from one small placebo-controlled study that propranolol did not exacerbate symptoms in patients with intermittent claudication (70). This has subsequently been supported by the results of several large placebo-controlled trials of beta-blockers in mild hypertension and reports of trials of the secondary prevention of myocardial infarction, in which intermittent claudication was not mentioned as an adverse effect, even though it was not a specific contraindication to inclusion (71). In addition, a comprehensive study of the effects of beta-adrenoceptor antagonists in patients with intermittent claudication did not show beta-blockade to be an independent risk factor for the disease (72). In men with chronic stable intermittent claudication, atenolol (50 mg bd) had no effect on walking distance or foot temperature (73). These findings have been confirmed in a recent meta-analysis of 11 randomized, controlled trials to determine whether beta-blockers exacerbate intermittent claudication (SEDA-17, 234). 

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