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Hypertension/High Blood Pressure Health Center

Study: Tenormin Not Best Blood Pressure Drug

Popular Beta-Blocker Doesn't Cut Risk of Heart Attack, Death
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Nov. 4, 2004 -- Tenormin, a popular blood-pressure-lowering drug, doesn't lower a person's risk of dying from heart disease, a new study suggests.

Introduced in 1976, Tenormin is used by millions of patients with heart disease. It's a member of the class of drugs known as beta-blockers, which lower a person's blood pressure. Tenormin works a little differently than other beta-blockers. Is this difference important?

Maybe it is. Bo Carlberg, MD, PhD, of the department of public health and clinical medicine at Umeå University Hospital in Sweden, and colleagues looked at earlier studies comparing Tenormin with an inactive placebo or with other blood-pressure drugs. The studies included some 24,000 patients followed for more than 4.5 years.

Their finding: Tenormin didn't lower patients' risk of heart attack or death from heart disease. It worked just as well as other drugs at lowering blood pressure. But patients taking Tenormin tended to die of heart disease more often than those treated with other blood-pressure-lowering drugs.

"We haven't shown that Tenormin is dangerous," Carlberg tells WebMD. "I am quite convinced there are still patients for whom Tenormin is the best choice. But Tenormin should not be a first-line treatment. Patients should ask their doctors, 'Is this the right drug for me?'"

Most doctors already try something else before putting a patient on Tenormin or other beta-blockers, says Richard Re, MD, head of the hypertension section and director of research at the Ochsner Clinic Foundation in New Orleans.

"Beta blockers are no longer a first-line treatment for high blood pressure," Re tells WebMD. "Doctors are thinking they should be used in select situations. There is a movement to use other drugs first."

Keep Taking Your Blood Pressure Drugs

Re notes that the Carlberg team's study is not a clinical trial. By pooling findings from earlier studies, the study raises a red flag but can't prove Tenormin doesn't work as well as other beta-blockers.

Carlberg says more study is needed. "It could be that the power of our study is too low to detect a benefit for Tenormin," he says. "Or it could be that Tenormin is in some way an inferior drug."

Meanwhile, he warns patients not to stop taking Tenormin.

"Don't change your medication without talking to your doctor," Carlberg says. "I say to some of my patients, 'OK, this drug does not have the best documentation, let's change to another drug.' To other patients I say, 'With your condition, I think Tenormin is the best choice for you."

Re agrees that blood-pressure treatment should be tailored to the individual patient.

"Beta-blockers are not for everybody, but for those who need them they are probably fine -- including Tenormin," he says.

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