Atenolol oral comparado con propranolol oral para hemangioma infantil / Oral atenolol compared to oral propranolol for infantile hemangioma

Introducción El hemangioma infantil corresponde al tumor vascular benigno más frecuente de la infancia, con una incidencia de 3 a 10%. Entre los pacientes que requieren tratamiento el uso oral de propranolol, un betabloqueador no selectivo de tipo lipofílico, es usualmente considerado como la terapia de elección. Sin embargo, su uso se ha asociado a diversos efectos adversos, relacionados con su acción ß-2, y a su capacidad de cruzar la barrera hematoencefálica. Debido a esto, el uso oral de atenolol, un betabloqueador selectivo de receptores ß-1, de tipo hidrofílico, podría representar una alternativa válida de tratamiento. Sin embargo, aún existe controversia en relación con la eficacia y seguridad del tratamiento con atenolol como monoterapia, en comparación con el uso de propranolol como monoterapia para esta condición. Métodos Se realizó una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el tamizaje de múltiples fuentes de información, incluyendo MEDLINE/PubMed, EMBASE, Cochrane, entre otras. Se extrajeron los datos desde las revisiones identificadas, se analizaron los datos de los estudios primarios, se realizó un metanálisis y se preparó una tabla de resumen de los resultados utilizando el método , GRADE. Resultados Se identificaron nueve revisiones sistemáticas, que en conjunto incluyeron 10 estudios primarios y tres ensayos aleatorizados. Se incluyeron los tres ensayos aleatorizados en el análisis del presente trabajo. Conclusiones El uso de atenolol oral como monoterapia, comparado con el uso de propranolol oral como monoterapia, podría resultar en poca o nula diferencia en cuanto a la probabilidad de remisión completa, la disminución del , la probabilidad de recaída posterior al tratamiento y el riesgo de presentar efectos adversos y efectos adversos severos, en el hemangioma infantil (certeza de la evidencia baja).

Introduction Infantile hemangioma is the most frequent benign vascular tumor in childhood, with an incidence of 3 to 10%. When patients require treatment, oral propranolol, a non-selective lipophilic beta-blocker, is usually considered the therapy of choice. However, its use has been associated with several adverse events related to its ß-2 action and its ability to cross the blood-brain barrier. Because of this, oral atenolol, a hydrophilic ß-1 receptor-selective beta-blocker, may represent a valid treatment alternative. Nonetheless, there is still controversy regarding the efficacy and safety of atenolol when compared with propranolol as monotherapy for this condition. Methods We searched Epistemonikos, the largest database of systematic reviews in health science, which is maintained by screening multiple sources of information, including MEDLINE/PubMed, EMBASE, and Cochrane, among others. Data were extracted from the identified reviews, data from the primary studies were analyzed, a meta-analysis was performed, and a summary table of the results was prepared using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. Results Nine systematic reviews were identified, including 10 primary studies and three randomized trials. The three randomized trials were included in the analysis of this investigation. Conclusion The use of oral atenolol compared with oral propranolol as monotherapies may result in little or no difference in terms of likelihood of complete remission, decrease in Hemangioma Activity Score, likelihood of post-treatment relapse, and risk of adverse events and severe adverse events, in infantile hemangioma (low certainty of evidence).

Eficacia del atenolol para prevenir la hipertensión perioperatoria en pacientes hipertensos durante la colecistectomía endoscópica

Introducción: La hipertensión perioperatoria constituye una de las principales alteraciones detectadas durante la colecistectomía video endoscópica. Se presume del efecto protector que tiene el atenolol con su acción beta bloqueadora en reducir esta condición morbosa. Objetivo: Evaluar la eficacia del atenolol en prevenir la hipertensión perioperatoria durante la colecistectomía video endoscópica en la unidad quirúrgica del Hospital Clínico Quirúrgico "Lucía Íñiguez Landín" de Holguín Método: Se realizó un estudio observacional, analítico, longitudinal y prospectivo de tipo cohorte con dos grupos paralelos de estudio, uno de tratamiento y un grupo control, desde enero a diciembre de 2018. El universo estuvo constituido por los 697 pacientes (N=697) atendidos en la consulta de evaluación preoperatoria y se tomó como muestra a 183 hipertensos (n=183) que se operaron por cirugía video endoscópica de litiasis vesicular, de ellos aleatorizados 95 al grupo de tratamiento con atenolol y 88 al grupo control. A los pacientes del grupo tratamiento se les administró atenolol 25 mg diarios durante 15 días antes de la cirugía. Las variables principales que se monitorizaron fueron las presiones arteriales sistólica, diastólica y media, y se emplearon indicadores para evaluar la efectividad del tratamiento. Resultados: Las presiones arteriales preoperatorias disminuyeron de forma significativa en el grupo de tratamiento con atenolol. La hipertensión perioperatoria fue más frecuente en el grupo control. El atenolol es un bloqueador selectivo de los receptores beta 1, ejerce su efecto hipotensor a nivel central al deprimir los centros cardiovasculares simpáticos como el vasomotor bulbar. Conclusiones: El tratamiento con atenolol fue eficaz en reducir la incidencia de hipertensión perioperatoria.

Introduction: Perioperative hypertension represents one of the leading alterations detected performing endoscopic cholecystectomy. It is presumed that atenolol has a protective effect able to reduce this morbid condition, likely due to its beta-blocking action. Objective: To assess the efficacy of atenolol on preventing perioperative hypertension performing laparoscopic cholecystectomy in the surgical unit of the Hospital Clínico Quirúrgico "Lucía Íñiguez Landín" of Holguín. Method: An observational, analytical, longitudinal and prospective cohort study was conducted with two study groups at the same time, experimental group and control group, from January to December, 2018. A total of 697 patients (N=697) evaluated in the preoperative consultation were involved in the study, the sample included 183 hypertensive patients (n=183) who underwent endoscopic surgery for gallbladder lithiasis, of whom 95 were randomized to the atenolol treatment group and 88 to the control group. Patients in the treatment group were administered atenolol at 25 mg daily for 15 days before surgery. Leading variables used were systolic, diastolic and mean arterial pressures, and specific indicators were used to evaluate treatment effectiveness. Results: Preoperative arterial pressures decreased significantly with the use of atenolol in the treatment group. Perioperative hypertension was more frequent in the control group. Atenolol is a selective beta 1 receptor blocker, who causes a hypertensive effects in the central level, depressing the bulbar vasomotor center. Conclusions: The results of this investigation show that the use of atenolol in treatment was an effective alternative, thus effectiveness reduce perioperative hypertension rate.

Introdução: A hipertensão perioperatória é uma das principais alterações detectadas durante a colecistectomia videoendoscópica. Presume-se o efeito protetor que o atenolol tem com sua ação betabloqueadora na redução dessa condição mórbida. Objetivo: Avaliar a eficácia do atenolol na prevenção da hipertensão perioperatória durante a colecistectomia videoendoscópica na unidade cirúrgica do Hospital Clínico Quirúrgico "Lucía Íñiguez Landín" of Holguín. Método: Foi realizado um estudo de coorte observacional, analítico, longitudinal e prospectivo com dois estudos paralelos grupos, um para tratamento e um grupo controle, de janeiro a dezembro de 2018. O universo foi composto por 697 pacientes (N=697) atendidos na consulta de avaliação pré-operatória e 183 pacientes hipertensos (n=183) foram tomados como amostra submetidos à videocirurgia para litíase biliar, dos quais 95 foram randomizados para o grupo tratamento com atenolol e 88 para o grupo controle. Os pacientes do grupo de tratamento receberam atenolol 25 mg diariamente por 15 dias antes da cirurgia. As principais variáveis monitoradas foram a pressão arterial sistólica, diastólica e média, e indicadores foram usados para avaliar a eficácia do tratamento. Resultados: A pressão arterial pré-operatória diminuiu significativamente no grupo de tratamento com atenolol. A hipertensão perioperatória foi mais frequente no grupo controle. O atenolol é um bloqueador seletivo dos receptores beta 1, exerce seu efeito hipotensor em nível central deprimindo os centros cardiovasculares simpáticos, como o vasomotor bulbar. Conclusões: O tratamento com atenolol foi eficaz na redução da incidência de hipertensão perioperatória.

Passive Cigarette Smoking Impact on Blood Pressure Response to Epinephrine and Felypressin in 1K1C Hypertensive Rats Treated or not with Atenolol / Impacto do Tabagismo Passivo na Resposta Pressórica à Epinefrina e Felipressina em Ratos Hipertensos 1K1C Tratados ou não com Atenolol

Abstract Background: Cigarette smoking is usually associated with hypertension and may modify vasoconstrictor response. Objective: The present study aimed to analyze and compare the interaction of passive cigarette smoking and hypertension on epinephrine and felypressin blood pressure effects after intravascular injection. Method: 45-day male Wistar rats had the main left renal artery partially constricted and the right kidney removed (1K1C model). Rats were placed in the chamber for exposition to passive cigarette smoking (10 cigarettes) during 10 min (6 days a week). Hypertensive rats received atenolol (90 mg/kg/day) by gavage for two weeks. Hypotensive and hypertensive response, response duration and heart rate were recorded from direct blood pressure values. The significance level was 5%. Results: Passive cigarette smoking increased maximal hypertensive response to epinephrine in normotensive and 1K1C-atenolol treated rats and to felypressin only in 1K1C-atenolol treated rats; it also reduced epinephrine hypotensive response. Epinephrine increased heart rate in normotensive and hypertensive passive smokers or non-smoker rats. Comparing the two vasoconstrictors, epinephrine showed greater hypertensive response in normotensive smokers, 1K1C-atenolol treated smokers and non-smokers. However, in normotensive-nonsmoker rats, felypressin showed a greater and longer hypertensive effect. Conclusions: Our results suggest that passive cigarette smoking may reduce epinephrine vasodilation and increase hypertensive response when compared to felypressin. Therefore, felypressin may be safe for hypertensive patients to avoid tachycardia and atenolol interaction, but for normotensive and non-smoker patients, epinephrine may be safer than felypressin.

Resumo Fundamento: O tabagismo geralmente está associado à hipertensão e pode modificar a resposta vasoconstritora. Objetivo: O presente estudo teve como objetivo analisar e comparar a interação do tabagismo passivo e hipertensão sobre os efeitos da epinefrina e felipressina na pressão arterial após injeção intravascular. Métodos: Ratos Wistar machos de 45 dias tiveram a artéria renal principal esquerda parcialmente obstruída e o rim direito removido (modelo 1K1C). Os ratos foram colocados na câmara para exposição ao tabagismo passivo (10 cigarros) durante 10 minutos (6 dias por semana). Ratos hipertensos receberam atenolol (90 mg/kg/dia) por gavagem durante duas semanas. A resposta hipotensora e hipertensiva, a duração da resposta e a frequência cardíaca foram registradas a partir da medida dos valores diretos da pressão arterial. O nível de significância foi de 5%. Resultados: O tabagismo passivo aumentou a resposta hipertensiva máxima à epinefrina em ratos normotensos e ratos 1K1C tratados com atenolol e à felipressina apenas em ratos 1K1C tratados com atenolol; também reduziu a resposta hipotensiva à epinefrina. A epinefrina aumentou a frequência cardíaca em ratos fumantes passivos ou não-fumantes, normotensos e hipertensos. Comparando os dois vasoconstritores, a epinefrina apresentou maior resposta hipertensiva em fumantes normotensos, ratos 1K1C fumantes e não fumantes tratados com atenolol. No entanto, em ratos normotensos e não fumantes, a felipressina apresentou um efeito hipertensivo maior e mais prolongado. Conclusões: Nossos resultados sugerem que o tabagismo passivo pode reduzir a vasodilatação da epinefrina e aumentar a resposta hipertensiva quando comparado à felipressina. Portanto, a felipressina pode ser segura para pacientes hipertensos, com o objetivo de evitar a interação entre taquicardia e atenolol, mas para pacientes normotensos e não-fumantes, a epinefrina pode ser mais segura que a felipressina.

Risk of dementia in patients taking beta blocker as antihypertensive treatment: a cross sectional study

Background: Hypertension is considered to be the third most important disease in the list of diseases in the south Asian region. Several trials have shown active treatment of hypertension reduced the incidence of dementia. This study was adopted to understand the cognitive status of patients using beta blockers for hypertension for a period of more than 5 years.Methods: The study was done during the period of August 2018 and September 2018. Patients taking beta blockers for atleast 5 years were included and was made to take the MMSE test which is scored out of 30 marks containing 11 questions, each of varying marks.Results: In the study, 54 patients were included, 8 out of 54 patients taking beta blockers obtained a score of 30 which is 15% of the study population taking beta blockers, 15 out of 54 patients taking beta blockers obtained a score of 29 which corresponds to 28% of the study population, 21 out of 54 individuals taking beta blockers obtained a score of 28 which is 39% of the population taking it, 7 patients taking beta blockers obtained a score of 27 pertaining to 13% of the population. One patient obtained a score of 26 and two patients scored 25 out of 30. The average score obtained was 28.2963.Conclusions: About 18.5% of the study population had scores below the average value of 28 in this study. This population is at higher risk of developing dementia in the future and need follow up.

Atenolol increases dental mineralization in male offspring of treated hypertensive rats and normotensive rats

Abstract This study evaluates how atenolol affects dental mineralization in offspring of female spontaneously hypertensive rats (fSHR) and normotensive Wistar rats (fW). fSHR and fW were treated with atenolol (100 mg/Kg/day, orally) during pregnancy and lactation. Non-treated fSHR and fW were the control groups. Enamel and dentin hardness were analyzed (Knoop, 15 g load, 10s) in mandibular incisor teeth (IT) and molar teeth (MT) obtained from the male offspring of atenolol-treated and non-treated fWistar and fSHR. Data were analyzed by ANOVA, followed by Tukey post hoc test (p < 0.05). Atenolol reduced the arterial blood pressure (SBP) in fSHR, but it did not change the SBP in fW. The offspring of non-treated fSHR had lower enamel (IT and MT) and dentin (IT) hardness than the offspring of non-treated fW (p < 0.05). Atenolol increased enamel and dentin hardness in the IT obtained from the offspring of fSHR and fW (p<0.05), but the offspring of fSHR presented higher values (p < 0.05). Atenolol did not alter enamel width in the IT obtained from any of the groups, but it increased enamel and dentin hardness in the IT obtained from the offspring of fSHR and fW. Atenolol affected the IT obtained from the offspring of fSHR. Atenolol increased only enamel hardness in the MT obtained from the offspring of fW. In conclusion, maternal hypertension reduces tooth hard tissues, and treatment with atenolol increases tooth hardness in male offspring of hypertensive and normotensive female rats.

Identification of amino alcohols related substances of atenolol by LC-Q-TOF/MS / 中国药科大学学报

@#To identify the amino alcohols related substances in atenolol. The related substances in atenolol and its stressed samples were pre-column derivatized with 9-fluorenylmethyl chloroformate. The separation was carried out on an Inertsil ODS-SP column (250 mm×4.6 mm, 5 μm) with linear gradient elution by methanol-ammonium acetate solution as the mobile phases. Electrospray positive ionization high-resolution Q-TOF/MS was used for the determination of the accurate masses and elemental compositions of the parent and fragment ions of these related substance derivatives. The structures of all the detected substances were identified by spectral analysis and synthetic analysis. Under the established conditions, atenolol and its amino alcohols related substances were well separated, and a total of 14 impurity peaks were detected and identified, of which 12 were related substances and 2 were derivatization reaction by-products. The established LC-MS method provides a reference for the examination and quality control of atenolol related substances.

Study of effect of propranolol, atenolol and celiprolol on exercise induced changes in heart rate, blood pressure and peak expiratory flow rate in healthy human volunteers

Background: Beta blockers are known to cause attenuation of sympathetic stimulation mediated increase in cardiovascular parameters. Very few studies are available in Indian set-up comparing these changes between different beta blockers available in market. The objective of the study was to compare efficacy and safety of propranolol, atenolol and celiprolol on heart rare, blood pressure and airway resistance, both at rest and during exercise.Methods: A prospective interventional study was carried out involving 72 healthy volunteers in the clinical pharmacology laboratory. Participants were divided in three groups of 24 each and given single oral doses of propranolol 40 mg, Atenolol 50 mg and celiprolol 40 mg was given to the participants. Exercise given in the form of step ladder test and hand grip dynamometer and effect on the different parameters like HR, SBP, DBP and PEFR were recorded before and immediately after exercise and compared.Results: All the three drugs were effective in attenuating the exercise induced cardiovascular parameters (p <0.05). Drug A cause change in HR, SBP, DBP and PEFR significantly (p <0.05). Change in SBP was more significant with drug B while significant difference was found in HR, SBP and DBP before and after exercise in drug C in both SL and HGD tests. No significant difference was found between the drug groups (p >0.05). No adverse effects were reported in the study participants.Conclusions: All the three drugs are effective in attenuating cardiovascular changes after sympathetic stimulation like exercise and there was no significant difference among them.

Hemangioma infantil: diagnóstico y manejo / Infantile hemangioma: diagnosis and management

El hemangioma infantil es el tumor de partes blandas más frecuente de la infancia; aparece durante las primeras semanas de vida. La fase de crecimiento progresivo ocurre durante el primer año de edad y la fase involutiva, hasta los 7 años. Puede ser único o múltiple, afectar un segmento del cuerpo o asociarse a otras anomalías en otros órganos. El tratamiento de elección para los hemangiomas que amenazan la vida o la función es el propranolol bajo un adecuado monitoreo médico; sin embargo, existen otras alternativas terapéuticas tanto para detener su crecimiento como para las secuelas. El manejo integral del hemangioma infantil varía de acuerdo a su presentación en cada paciente, de ahí la importancia de conocer su comportamiento para un adecuado diagnóstico, tratamiento y pronóstico. Este artículo brinda un enfoque práctico para el diagnóstico del hemangioma infantil, así como pautas y recomendaciones para el tratamiento sobre la base de la literatura.Palabras clave: atenolol, diagnóstico clínico, hemangioma, propranolol

Infantile hemangioma is the most frequent soft tissue tumor of childhood. It appears during the first weeks of life with a progressive growth during the first year of age and a regression phase until the seventh year of age. It can be single or multiple, affect one segment of the body or be associated with other abnormalities in other organs. Propranolol is the treatment of choice for hemangiomas that threaten life or function under adequate medical monitoring, however there are other therapeutic alternatives both to stop the proliferative phase and for the sequels. The integral management of the infantile hemangioma varies according to the presentation in each patient, hence the importance of knowing its behavior for an adequate diagnosis, treatment and prognosis. This article provides a practical approach for the diagnosis of infantile hemangioma, as well as guidelines and recommendations for treatment based on the literature

The role of atenolol in the modulation of the expression of genes encoding pro- (caspase-1) and anti- (Bcl2L1) apoptotic proteins in endothelial cells exposed to intestinal ischemia and reperfusion in rats

Abstract Purpose: To investigate the role of atenolol in the gene expression of caspase 1 (Casp1) and Bcl2L1 on vascular endothelium of rat intestine after ischemia and reperfusion (IR). Methods: Eighteen adult male Wistar rats were randomly divided into 3 groups (n=6): SG (Sham group): no clamping of the superior mesenteric artery; IRG: IR plus saline group: IRG+At: IR plus Atenolol group. Rats from IRG and IRG+At were subjected to 60 min of intestinal ischemia and 120 min of reperfusion. Atenolol (2mg/kg) or saline were injected in the femoral vein 5 min before ischemia, 5 min and 55 min after reperfusion. Thereafter, intestinal segments were appropriately removed and processed for Endothelial Cell Biology Rat RT2 Profiler PCR Array. Results: the anti-apoptotic Bcl2L1 gene expression was significantly down-regulated (-1.10) in the IRG and significantly up-regulated in the IRG+At (+14.15). Meanwhile, despite Casp1 gene expression was upregulated in both groups, it was significantly higher in the IRG (+35.06) than the IRG+At (+6.68). Conclusions: Atenolol presents antiapoptotic effects on rat intestine subjected to IR partly by the up-regulation of the anti-apoptotic Bcl2L1 gene expression. Moreover, atenolol can mitigate the pro-apoptotic and pro-inflammatory effects of Casp1 gene on rat intestine after IR.

Monitoring effects of atenolol versus olmesartan medoxomil on metabolic parameters

Background: The increase in CVS morbidity and mortality could be significantly reduced by control of SBP and DBP, as well as reduction in Hyperlipidemia.Methods: The patients of stage-1 HTN with either sex according to JNC VII criteria were included and were followed up every 2 weeks from baseline upto 12 weeks. The randomized patients were divided into two groups to receive beta blocker viz. Atenolol 50 mg (group A, N=50) and ARB Olmesartan medoxomil 40 mg (group B, N=50).Results: The average Total cholesterol measured among Group A subjects was significantly increased by 1.8% by the end of 12th week whereas the average cholesterol measured among Group B subjects at baseline period was reduced by 7.9% after 12 weeks therapy. The average HDL measured among Group A subjects at baseline period significantly reduces by 5.9% by the end of 12th week whereas the HDL levels measured among Group B subjects at baseline period was significantly increased by after 12 weeks therapy. The average Triglyceride (TG) levels measured among Group A subjects at baseline period was significantly increased by 12.4% by the end of 12th week whereas the Triglyceride (TG) levels measured among Group B subjects at baseline period was significantly reduced by 9.5% after 12 weeks therapy. The average LDL levels measured among Group A subjects at baseline period was significantly increased by 1.5% by the end of 12thweek whereas the average LDL measured among Group B subjects at baseline period was significantly reduced by 11.2% to after 12 weeks therapy. The average VLDL levels measured among Group A subjects at baseline period was significantly increased by 12.4% by the end of 12th week whereas the average VLDL measured among Group B subjects at baseline period was significantly reduced by 9.5% after 12 weeks therapy.Conclusions: ARB- Olmesartan medoxomil is a better drug than beta blocker-Atenolol as it leads to greater deduction in lipid profile.

A comparative study of effects of nebivolol and atenolol on blood pressure and lipid profile in patients of mild to moderate hypertension

Background: Beta blockers have been used in the treatment of hypertension, since last four decades and are widely accepted as the first-line treatment for hypertension. Nebivolol, a third generation ?-blocker has highest ?1 selectivity and is devoid of intrinsic sympathomimetic activity. Along with peripheral vasodilatation and nitric oxide (NO)-induced benefits such as antioxidant activity and reversal of endothelial dysfunction, nebivolol promotes better protection from cardiovascular events. The objective of the study was to compare the effects of atenolol and nebivolol on both blood pressure and lipid profile in patients of mild to moderate hypertension.Methods: This was a prospective, randomized, parallel, open labelled study. Patients were recruited from the medicine out-patient department (OPD) and cardiology OPD. A total of 100 patients were enrolled in the study. 50 patients were allocated to atenolol group and 50 patients to nebivolol group. BP and baseline investigations such as lipid profile were performed. Tests to determine lipid profile were performed on the first visit (Week 0) and at 24 weeks. Continuous variables between the two treatment groups were analyzed by unpaired t-test. Efficacy endpoints within the group were analyzed by using paired t-test.Results: All the lipid levels except HDL-C were increased with atenolol therapy. At 24 weeks, atenolol therapy led to increase in LDL-C, VLDL-C, TC and TG which was highly significant (p<0.0001). HDL levels were decreased at 24 weeks which was also statistically highly significant (p<0.0001). The mean values of lipids in nebivolol group at baseline and at 24 weeks. At 24 weeks, nebivolol therapy led to changes in LDL-C, VLDL-C, HDL-C, TC and TG which was not statistically significant (p>0.05).Conclusions: From study it can be concluded that atenolol and nebivolol are equally effective in reducing BP but atenolol worsens lipid profile as compared to nebivolol.

Effect of atenolol pre-treatment in heart damage in a model of intestinal ischemia-reperfusion

Abstract Purpose: To investigate the effects of atenolol in inflammatory mediator and oxidative stress in a myocardial injury by intestinal ischemia/reperfusion in rat model. Methods: Adult Wistar male rats were randomly (n=8), anesthetized and divided in: Sham: submitted to operation only; group SS+IR: intravenous saline infusion following superior mesenteric artery occlusion during 60 minutes (ischemia) and open for 120 minutes (reperfusion); group AT+IR: intravenous atenolol infusion (2 mg/kg) following superior mesenteric artery occlusion during 60 minutes (ischemia) and open for 120 minutes (reperfusion); and group AT+I+AT+R: intravenous atenolol infusion following superior mesenteric artery occlusion during 60 minutes (ischemia) and in the time 45 minutes other atenolol doses were administrated and the artery was open for 120 minutes (reperfusion), all animals were submitted to muscular relaxation for mechanical ventilation. In the end of experiment the animals were euthanized and the hearts tissue were morphology analyzed by histology and malondialdehyde by ELISA, and the plasma were analyzed for tumor necrosis factor-alpha by ELISA. Results: The group SS+IR demonstrated the higher malondialdehyde levels when compared with the atenolol treated-groups (p=0.001) in the heart tissue. The tumor necrosis factor-alpha level in plasma decrease in the treated groups when compared with SS+IR group (p=0.001). Histology analyses demonstrate pyknosis, edema, cellular vacuolization, presence of inflammatory infiltrate and band contraction in the heart tissue of the rats. Conclusion: Atenolol significantly reduce the degree of cardiac damage after intestinal ischemia-reperfusion.

Efecto de la administración de atenolol o nebivolol sobre la variabilidad de la presión arterial y su impacto sobre el daño de órgano blanco en ratas espontáneamente hipertensas / Effect of Atenolol or Nebivolol Administration on Blood Pressure Variability and its Impact on White Organ Damage in Spontaneously Hypertensive Rats

Introducción: Tradicionalmente se ha considerado que el riesgo cardiovascular asociado con la hipertensión es producto de la elevación sostenida de la presión arterial, que lleva al daño de órgano blanco. En los últimos años se ha descripto que otros factores, como la variabilidad de la presión arterial y la presión arterial central, también afectan directamente el daño de órgano blanco. Objetivo: Determinar los efectos de la administración crónica de atenolol o nebivolol sobre la variabilidad de la presión arterial a corto plazo y el daño de órgano blanco a nivel del ventrículo izquierdo y de la aorta. Material y métodos: Se incluyeron ratas espontáneamente hipertensas (REH) que fueron tratadas durante 8 semanas con una única administración diaria de atenolol, nebivolol o vehículo. Se determinaron la presión arterial y su variabilidad a corto plazo y se realizó ecocardiografía. Se extrajeron el ventrículo izquierdo y la aorta torácica para cuantificar la expresión del factor de crecimiento transformante b y realizar estudios histológicos. Resultados: El tratamiento crónico con nebivolol redujo la presión arterial media (PAM) y su variabilidad en mayor medida que el atenolol (PAM WKY: 118,6 ± 8,0 mm Hg; REH: 174,6 ± 2,1ª mm Hg; REH-atenolol: 155,2 ± 2,1a, b mm Hg; REH-nebivolol: 122,3 ± 2,3b, c mm Hg; desviación estándar de la PAM WKY: 3,8 ± 0,2 mm Hg; REH: 6,2 ± 0,3ª mm Hg; REH-atenolol: 5,2 ± 0,3a, b mm Hg; REH-nebivolol: 4,2 ± 0,2b, c mm Hg; ªp < 0,05 vs. ratas WKY; b p < 0,05 vs. REH; c p < 0,05 vs. REH-atenolol). Conclusiones: El análisis del daño de órgano blanco establece que el nebivolol reduce el contenido de fibrosis ventricular, disminuye el espesor de la media aórtica e induce una mayor reducción de la sobreexpresión del factor de crecimiento transformante b en ambos órganos en comparación con REH tratadas con vehículo o atenolol. Estos hallazgos sugieren que la mayor reducción de la presión arterial central, junto con la disminución de la labilidad de la presión arterial, contribuiría en la superior protección del daño de órgano blanco por el nebivolol respecto del atenolol.

Imunomarcação para TRAP em tecido de reparação óssea de ratos espontaneamente hipertensos (SHR) tratados com Atenolol / Immunostaining for TRAP in bone healing tissue of Spontaneously Hypertensive Rats (SHR) treated with Atenolol

Introdução: A hipertensão arterial tem sido um dos maiores problemas de saúde no mundo, com grandes alterações para as doenças cardiovasculares e renais. O tecido ósseo tem função importante no suporte, proteção e locomoção e está sob o controle de fatores sistêmicos como hormônios e fatores locais, entre eles os fatores de crescimento e citocinas. A Fosfatase Ácida Tartarato Resistente (TRAP) é uma enzima que faz parte da família das fosfatases ácidas e apresenta localização intracelular; mais especificamente dentro do compartimento lisossomal de osteoclasto, macrófagos e células dendríticas, tem sido utilizada como um marcador histoquímico da atividade osteoclástica. Objetivos: Avaliar a expressão da proteína TRAP em alvéolos dentários de ratos hipertensos (SHR) e normotensos tratados ou não com atenolol. Métodos: Neste estudo foram utilizados 4 grupos de ratos sendo: 1) W (wistar sem tratamento), 2) WT (wistar tratado com atenolol), 3) S (SHR sem tratamento) e 4) ST (SHR tratado com atenolol), submetidos a exodontia do incisivo superior direito, com eutanásia no 7º, 14º, 21 e 28º dia pós-operatório. A análise dos mecanismos biológicos envolvidos no processo de reparo alveolar foi obtida pela análise da expressão de proteínas TRAP por meio da técnica de imunoistoquímica. Os resultados foram analisados pela média e erro padrão da média e aplicado o teste paramétrico ANOVA, com pos-test de Tukey para avaliar os períodos dentro de cada grupo e entre os grupos, sendo consideradas as diferenças significativas quando p<0,05. Resultados: Os resultados mostraram que a marcação TRAP aumenta em alvéolo dentais de ratos Wistar durante todos os períodos pós ­ operatórios. A marcação TRAP aumenta apenas ao 14o nos dias de reparação alveolar em alvéolo dental de SHR não tratados. O atenolol não altera o processo de reparo alveolar em ratos Wistar, porém o atenolol promoveu a redução da marcação de TRAP em SHR ao 14º dia. Conclusão: A hipertensão aumenta a expressão da proteína TRAP no 14o dia pós-cirúrgico de reparação alveolar e o atenolol promove redução da marcação aumentada de TRAP ao 14º dia pós-cirúrgico em alvéolos de SHR(AU)

Introduction: Arterial hypertension has been one of the world's biggest health problems, with considerable alterations for cardiovascular and renal diseases. The bone tissue has an important role in support, protection and locomotion and is controlled by systemic factors like hormones and local factors, such as growth factors and cytokines. The Tartrate-resistant Acid Phosphatase (TRAP) is an enzyme that belongs to the Acid Phosphatases family and has an intracellular location, more specifically inside the lysosomal compartment of osteoclasts, macrophages and dendritic cells. It has been used as a histochemical marker of the osteoclast activity. Objectives: Evaluate TRAP protein's expression in the dental alveoli of normotensive and hypertensive rats (SHR) treated or not treated with Atenolol. Methods: In this study, four groups of rats were used: 1) W (with no treatment), 2) WT (wistar treated with Atenolol), 3) S (SHR without treatment) and 4) ST (SHR treated with Atenolol), all of which underwent exodontia of the upper right incisor with euthanasia on the 7th, 14th, 21st and 28th day after the operation. The analysis of the biological mechanisms involved in the process of alveolar repair was obtained by the expression of TRAP proteins in the alveolar process through an immunohistochemistry technique. The results were analyzed through the average and its standard error. The parametric test ANOVA was applied with Tukey's posttest were applied to evaluate the periods within each group and between the groups, considering the significant differences when p< 0,05. Results: The results demonstrated that TRAP staining increases in the dental alveoli of Wistar rats during all the post-surgical periods. TRAP staining increases only on the 14th day of alveolar recovery in the dental alveoli of non-treated SHR. Atenolol does not change the process of alveolar repair in Wistar rats, but Atenolol promoted the reduction of TRAP staining among SHR on the 14th day. Conclusion: Hypertension increases the expression of TRAP proteins on the 14th alveolar recovery postsurgical day and Atenolol promotes the reduction of the increased TRAP staining on the 14th postsurgical day in SHR's alveoli(AU)

Comparison of Therapeutic Efficacy and Safety of Nifedipine and Atenolol in the Treatment of Moderate Mitral Stenosis in Sinus Rhythm Rheumatic Heart Disease / 中国药房

OBJECTIVE:To compare therapeutic efficacy and safety of nifedipine and atenolol in the treatment of moderate mitral stenosis in sinus rhythm rheumatic heart disease.METHODS:In retrospective analysis,a total of 108 patients with moderate mitral stenosis in sinus rhythm rheumatic heart disease were divided into nifedipine group (54 cases) and atenolol group (54 cases)according to therapeutic regimen.Based on routine treatment,nifedipine group was given Nifedipine sustained-release tablet (Ⅰ)20 mg orally,once a day.Atenolol group was given Atenolol tablet 50 mg orally,once a day.Both groups received treatment for 8 weeks.Clinical efficacies as well as resting heart rate,cardiac function indexes (LVESV,LVEDV,LVET,LVEF,LVMI,E/A),BNP and hs-CRP levels,6 min walking distance,the occurrence of ADR before and after treatment were observed in 2 groups.RESULTS:There was no statistical significance in total response rate and the incidence of ADR between 2 groups (P＞0.05).Before treatment,there was no statistical significance in the levels of resting heart rate,cardiac function indexes,BNP and hs-CRP,6 min walking distance between 2 group (P＞0.05).After treatment,resting heart rate,LVMI,BNP and hs-CRP levels of 2 groups were significantly lower than before treatment,and LVMI,BNP and hs-CRP levels of nifedipine group were significantly lower than those of atenolol group;LVESV,LVEDV,LVET,LVEF,E/A and 6 min walking distance of 2 groups were significantly higher or longer than before treatment,and LVESV,LVET,LVEF,E/A and 6 min walking distance of nifedipine group were significantly higher than those of atenolol group;there was statistical significance (P＜0.05 or P＜0.01).There was no statistical significance in resting heart rate and LVEDV between 2 groups (P＞0.05).CONCLUSIONS:Based on routine treatment,nifedipine is similar to atenolol for moderate mitral stenosis in sinus rhythm rheumatic heart disease in therapeutic efficacy and safety.But nifedipine is better than atenolol in improving cardiac function,neuroendocrine factor levels and exercise ability.

Comparison of Therapeutic Efficacy and Safety of Nifedipine and Atenolol in the Treatment of Moderate Mitral Stenosis in Sinus Rhythm Rheumatic Heart Disease / 中国药房

OBJECTIVE:To compare therapeutic efficacy and safety of nifedipine and atenolol in the treatment of moderate mitral stenosis in sinus rhythm rheumatic heart disease.METHODS:In retrospective analysis,a total of 108 patients with moderate mitral stenosis in sinus rhythm rheumatic heart disease were divided into nifedipine group (54 cases) and atenolol group (54 cases)according to therapeutic regimen.Based on routine treatment,nifedipine group was given Nifedipine sustained-release tablet (Ⅰ)20 mg orally,once a day.Atenolol group was given Atenolol tablet 50 mg orally,once a day.Both groups received treatment for 8 weeks.Clinical efficacies as well as resting heart rate,cardiac function indexes (LVESV,LVEDV,LVET,LVEF,LVMI,E/A),BNP and hs-CRP levels,6 min walking distance,the occurrence of ADR before and after treatment were observed in 2 groups.RESULTS:There was no statistical significance in total response rate and the incidence of ADR between 2 groups (P＞0.05).Before treatment,there was no statistical significance in the levels of resting heart rate,cardiac function indexes,BNP and hs-CRP,6 min walking distance between 2 group (P＞0.05).After treatment,resting heart rate,LVMI,BNP and hs-CRP levels of 2 groups were significantly lower than before treatment,and LVMI,BNP and hs-CRP levels of nifedipine group were significantly lower than those of atenolol group;LVESV,LVEDV,LVET,LVEF,E/A and 6 min walking distance of 2 groups were significantly higher or longer than before treatment,and LVESV,LVET,LVEF,E/A and 6 min walking distance of nifedipine group were significantly higher than those of atenolol group;there was statistical significance (P＜0.05 or P＜0.01).There was no statistical significance in resting heart rate and LVEDV between 2 groups (P＞0.05).CONCLUSIONS:Based on routine treatment,nifedipine is similar to atenolol for moderate mitral stenosis in sinus rhythm rheumatic heart disease in therapeutic efficacy and safety.But nifedipine is better than atenolol in improving cardiac function,neuroendocrine factor levels and exercise ability.

The clinical efficacy and safety of nitroglycerin combined with atenolol in the treatment of coronary heart disease / 中国生化药物杂志

Objective To study the clinical efficacy and safety of nitroglycerin combined with atenolol in the treatment of coronary heart disease.Methods From February 2014 to November 2016, 114 cases of coronary heart disease patients treated in Zhongshan hospital were selected, all patients were randomly divided into experimental group and control group, the patients in experimental group were treated with nitroglycerin combined with atenolol, and the patients in control group were treated with nitroglycerin, the therapeutic effects of two groups were observed, the adverse reactions of the two groups were compared.Results After treatment, the total effective rate of the treatment group was 93% higher than that of the control group(78.9%), the difference was statistically significant(P< 0.05);The total effective rate of ECG in the experimental group was 89.5% higher than that in the control group(73.7%), the difference was statistically significant(P<0.05);There were 2 cases(3.5%)of adverse reactions in the experimental group and there were 11 cases(19.3%)of adverse reactions in the control group, which was significantly lower in the experimental group than that in the control group, the difference was statistically significant(P<0.05).Conclusion Phenyl bromide Malone and colchicine had good clinical curative effect in the treatment of chronic gout.

Clinical effects of Zhenyuan oral liquid combined with atenolol in treatment of cardiac neurosis / 中国生化药物杂志

Objective To observe clinical effects Zhenyuan oral liquid combined with atenolol in treatment of cardiac neurosis.Methods130 patients with cardiac neurosis from department of cardiology from January 2014 to November 2016 were grouped two groups and each with 65 cases.The control group were treated with atenolol, and observa-tion group was treated another with Zhenyuan oral liquid.Clinical effects and adverse reac-tion of two groups were compared.Results①Effective rate of observation group was 93.85%,higher than control group 76.92%(P<0.05).②Main symptom score and HAMA score of observation group were(4.08±1.38,13.05±2.58)point,lower than that of control group(6.15±1.56,17.20±2.97)point(all P<0.05).③ SDNN,SDANN,rMSSD and PNN50 level of observation group were (116.9±7.3ms,111.0±6.7ms,41.59±3.68ms,13.02±1.14%),higher than that of control group(99.5±6.2ms,95.3±5.4ms,35.92±3.59ms,10.89±1.09%)(all P<0.05).④ Proportion of T wave anomaly and ventricular premature beat of observation group were(7.69%,7.69%),lower than that of control group (20.00%,16.92%)(all P<0.05).⑤Adverse reaction ratio of observation group was 7.69%,higher than that of control group 10.77%,but there was no significant difference between groups.ConclusionZhenyu-an oral liquid can improve effects of patients with cardiac neurosis and medication safety.

Assessment of Effect of Atenolol and Enalapril on Trace Elements in Pre and Postmenopausal Women with Essential Hypertension

Background:  Studies conducted in recent times have reported the involvement of trace elements in the pathogenesis of certain cardiovascular diseases particularly hypertension. So, the present study was planned to evaluate the influence of the antihypertensive drugs enalapril and atenolol on blood pressure and serum concentration of zinc, magnesium, lead, aluminum and vanadium. Methods:  For the study, selection of 30 pre and 30 post-menopausal women patients with mild to moderate essential hypertension and 60 normal controls for both the groups was done.  The age group of premenopausal hypertensive women was 30-50 years and for postmenopausal hypertensive women it was 50-70 years. Atenolol (10-40 mg/day) was prescribed to half of the patients from both the study groups and the other half was prescribed Enalapril (5-20mg/day). The assessment of trace elements was done during the follow up before and after 3, 6, 12 months of treatment. Results: Effectiveness of both the drugs, Atenolol and Enalapril were found equal in deceasing blood pressure. A significant increase in the serum level of lead (P<0.05), significant decrease in the level of Magnesium (P<0.05), non-significant increase in the level of zinc and no change in the level of Vanadium and aluminum was observed in newly diagnosed pre-and postmenopausal women with essential hypertension as compared to normal control. Conclusions: There is association of high level of blood lead and low level of magnesium to essential hypertension in pre and postmenopausal women without any renal disease. High plasma vanadium levels were not found in hypertensives with normal renal functions with respect to control.