WORLD JOURNAL OF PHARMACY AND PHARMACEUTICAL SCIENCES

Ajesh. World Journal of Pharmacy and Pharmaceutical Sciences

SJIF Impact Factor 7.632

Volume 9, Issue 3, 902-914 Review Article ISSN 2278 – 4357

A REVIEW ON ATENOLOL

Ajesh Chauhan*

Assistant Professor, Atterna Sonipat Haryana (HR) India 131023.

Article Received on ABSTARCT

07 Jan. 2020,
Atenolol, 4-(2-hydroxy-3-[(1-methylethyl) amino] propoxy)
Revised on 28 Jan. 2020,
Accepted on 18 Feb. 2020 benzeneacetamide is a β1-selective (cardioselective) adrenoreceptor
DOI: 10.20959/wjpps20203-15671 antagonist drug commonly used for management of hypertension,
prevention of heart diseases as angina pectoris and control of some
*Corresponding Author forms of cardiac arrithymia. it DA zwas first introduced in 1976 and
Mr. Ajesh Chauhan
has been approved by US FDA in August 1981 as therapeutic agent for
Assistant Professor, Atterna
hypertension and coronary artery disease. The present review outlines
Sonipat Haryana (HR) India
131023. the pharmacology and importance of atenolol in medical field along
with its dosage and side effects.
INTRODUCTION
Beta blockers are one of the safest and most effective antihypertensive drugs. So impressive
have been their utility in hypertension that all Joint National committees (JNcs) from JNc 1 to
the latest JNc7 have recommended betablockers as first line of therapy in hypertension. Beta
receptors are found on cells in the heart. When adrenaline activates a beta receptor, blood
pressure and heart rate go up. Beta blockers prevent adrenaline from affecting beta receptors
in your blood vessels and heart. This causes blood vessels to relax. By relaxing the vessels,
beta blockers help to lower blood pressure and reduce chest pain. They also help to decrease
the heart's demand for oxygen.

Beta blockers don’t permanently change blood pressure and chest pain. Instead, they help to
manage the symptoms.

Atenolol belongs to beta blocker class of drugs. A class of drugs is a group of medications
that work in a similar way. These drugs are often used to treat similar conditions. Atenolol is
a cardioselective β-blocker, selective β1 adrenergic antagonist. Atenolol was first introduced

in 1976 and has been approved by the US FDA from August 1981 as a therapeutic agent for

www.wjpps.com Vol 9, Issue 3, 2020. 902

Ajesh. World Journal of Pharmacy and Pharmaceutical Sciences

both hypertension and coronary artery disease. Atenolol is one of the most commonly
prescribed betablockers all over the world with more than 40 million prescriptions per year in
the US alone.

It is widely used in the treatment of hypertension and angina pectoris, arrhythmias and
myocardial infarction. This is also used for prophylactic treatment of migraine. It was
specifically developed to pass through the blood brain barrier. Atenolol being a cardio
selective beta blocker does not show adverse effects when given to patients suffering from
bronchial asthma and diabetes mellitus. Patient compliance is better with atenolol because it
is given once a day. It is also used to treat other conditions including dysautonomia, anxiety
and hyperthyroidism.[1-6]

Struture and properties

Chemically Atenolol may be described as a benzene acetamide, 4-[21 – hydroxy – 31 –[(1-

methyl ethyl) amino] propoxy] benzeneacetamide. Molecular weight of Atenolol is 266.34. It

is a relatively polar hydrophilic compound with water solubility of 26.5 mg/ml at 370c and a
log partition coefficient (octanol / water) of 0.23. Atenolol is a white or almost white powder.
It is sparingly soluble in water; soluble in ethanol (~750 g/L) TS; slightly soluble in
dichloromethane R.[7, 8]

Figure 1. Chemical structure of Atenolol.

Pharmacokinetics
Atenolol is a β1 selective antagonist with lowest lipid solubility among all betablockers. It
differs from Pindolol and Proponolol in that it does not have an intrinsic sympathomimetic
action or membrane stabilising activity. It acts by competing with catecholamines for binding

www.wjpps.com Vol 9, Issue 3, 2020. 903

Ajesh. World Journal of Pharmacy and Pharmaceutical Sciences

at β1 adrenergic receptors in the heart and vascular smooth muscle, thus inhibiting
sympathetic stimulation. This results in reduction in heart rate, cardiac output, systolic and
diastolic blood pressure. Reduction in peripheral resistance is gradually seen with chronic
therapy. Endocrine and metabolic actions of Atenolol include lowering of plasma renin
activity and free fatty acid levels. Although Atenolol may prolong insulin-induced
hypoglycemia, this is less than that of nonselective beta-blockers. Atenolol has a complex
effect on lipid metabolism; however, it’s less than that of other nonselective betablockers.
betablockers have a little effect on LdL but do increase plasma VLdL and triglyceride levels
and 4 lower plasma HdL levels. Atenolol is hydrophilic, hence, relatively lower
concentrations are found in brain tissue. Absorption after an oral dose is often incomplete and
peak plasma levels are obtained 2 – 4 hours later. Although plasma, half- life is 6 – 8 hours, it
is increased in renal failure as the major route of excretion is through the kidneys.[9]

Pharmacodynamics[12]
Atenolol is a β-adrenoceptor blocking drug without partial agonist (sympathomimetic) or
membrane stabilising properties. It appears to be relatively selective for cardiac β1-receptors,
although some deterioration in airway function can occur in patients with asthma receiving
atenolol, as with other cardioselective β-blockers. However, such changes are clearly less
severe than those seen with non-selective β-blockers, such as propranolol, and in some
studies atenolol had a lesser effect than the other cardioselective β-blockers. Atenolol can be
cautiously administered to patients with obstructive airways disease provided the patient also
receives treatment with optimal doses of a β2-adrenoceptor agonist bronchodilator drug.
When administered to hypertensive patients (usually with mild to moderate essential
hypertension) in studies which were essentially pharmacodynamic investigations, atenolol
reduced both systolic and diastolic blood pressures by about 15%. The dose-response curve in
such studies was relatively flat, suggesting that the use of a fixed dose may be justifiable in
most patients. The maximum effect usually occurred with a dose of 100 or 200mg, most of
the antihypertensive effect occurring by the third day of treatment. As with other β-blockers,
the reduction in blood pressure with atenolol is consistently accompanied by a reduction in
heart rate (about 15 to 25%) and cardiac output (usually about 20%). Atenolol is a β-
adrenoceptor blocking drug without partial agonist (sympathomimetic) or membrane
stabilising properties. It appears to be relatively selective for cardiac β1-receptors, although
some deterioration in airway function can occur in patients with asthma receiving atenolol, as
with other cardioselective β-blockers. However, such changes are clearly less severe than

www.wjpps.com Vol 9, Issue 3, 2020. 904

Ajesh. World Journal of Pharmacy and Pharmaceutical Sciences

those seen with non-selective β-blockers, such as propranolol, and in some studies atenolol
had a lesser effect than the other cardioselective β-blockers. Atenolol can be cautiously
administered to patients with obstructive airways disease provided the patient also receives
treatment with optimal doses of a β2-adrenoceptor agonist bronchodilator drug. When
administered to hypertensive patients (usually with mild to moderate essential hypertension)
in studies which were essentially pharmacodynamic investigations, atenolol reduced both
systolic and diastolic blood pressures by about 15%. The dose-response curve in such studies
was relatively flat, suggesting that the use of a fixed dose may be justifiable in most patients.
The maximum effect usually occurred with a dose of 100 or 200mg, most of the
antihypertensive effect occurring by the third day of treatment. As with other β-blockers, the
reduction in blood pressure with atenolol is consistently accompanied by a reduction in heart
rate (about 15 to 25%) and cardiac output (usually about 20%). In patients with coronary
artery disease, atenolol produces changes in myocardial blood flow which resemble those
seen with other β-blockers, regional myocardial blood flow beingdecreased in both normal
and poststenotic areas but to a slightly greater extent in poststenotic areas. Resting
myocardial oxygen consumption is also reduced in such patients, as is seen with other β-
blockers. As is expected with a β-blocking drug lacking partial agonist activity, atenolol
increases AV conduction time (by about 15%). Sinus cycle length, sinus node recovery time
and atrial refractoriness are also similarly increased.

Uses[11]
Labeled indications
Acute MI: Management of hemodynamically stable patients with definite or suspected acute
MI to reduce cardiovascular mortality.

Guideline recommendations: According to the American College of Cardiology

Foundation/American Heart Association (ACC/AHA) guidelines for the management of ST-
elevation myocardial infarction (STEMI) and the ACC/AHA guidelines for the management
of non-ST-elevation ACS (NSTE-ACS), oral beta-blockers should be initiated within the first
24 hours unless the patient has signs of heart failure, evidence of a low-output state, an
increased risk for cardiogenic shock, or other contraindications. However, recommendations
do not specify any particular beta-blocking agent for optimal treatment of NSTE-ACS. Thus,
clinicians must use practical experience to determine proper therapy in managing patients.

www.wjpps.com Vol 9, Issue 3, 2020. 905

Ajesh. World Journal of Pharmacy and Pharmaceutical Sciences

Angina pectoris caused by coronary atherosclerosis: Long-term management of patients

with angina pectoris.

Hypertension: Management of hypertension. Beta-blockers are not recommended as first-

line therapy.

Off label uses

Atrial fibrillation (rate control)
The use of beta-blockers, including atenolol, for ventricular rate control in patients with
paroxysmal, persistent, or permanent AF is effective and recommended for this condition.

Supraventricular tachycardia (AV nodal reentrant tachycardia [AVNRT], AV

reentrant tachycardia [AVRT], atrial flutter, focal atrial tachycardia [AT])
The use of an oral beta-blocker, including atenolol, is an effective and recommended
treatment option for the ongoing management of a variety of symptomatic supraventricular
tachycardias (AVNRT, AVRT, focal AT) without pre-excitation in patients who are not
candidates for, or prefer not to undergo catheter ablation. Oral beta-blockers, including
atenolol, may also be useful for the ongoing management (acute rate control) in
hemodynamically stable patients with atrial flutter.

Thyrotoxicosis
Beta-blockers, including atenolol, are effective and recommended in the treatment of
symptomatic thyrotoxicosis. Beta-blockers should also be considered in asymptomatic
patients who are at increased risk of complications due to worsening hyperthyroidism.

Ventricular arrhythmias
In patients with arrhythmogenic right ventricular cardiomyopathy (ARVC), data from
observational studies suggest that atenolol may be beneficial at reducing ventricular
arrhythmias [Marcus 2009]. The American Heart Association/American College of
Cardiology/Heart Rhythm Society (AHA/ACC/HRS) guideline for management of patients
with ventricular arrhythmias and prevention of sudden cardiac death recommends beta-
blocker therapy in patients with ARVC and history of ventricular arrhythmia and suggests
that beta-blockers may be considered in patients without a history of ventricular arrhythmia.
In patients with congenital long QT syndrome, data from observational studies suggest that
beta-blockers may be beneficial at reducing the risk of cardiac events, including ventricular

www.wjpps.com Vol 9, Issue 3, 2020. 906

Ajesh. World Journal of Pharmacy and Pharmaceutical Sciences

arrhythmias, especially in patients with long QT syndrome type 1 or type 2 [Chockalingam

2012], [Goldenberg 2010], [Moss 2000], [Sauer 2007]. Atenolol, nadolol, and propranolol
may be preferred choices for patients with long QT syndrome based on the currently
available data and American Heart Association/American College of Cardiology/Heart
Rhythm Society (AHA/ACC/HRS) guideline for management of patients with ventricular
arrhythmias and prevention of sudden cardiac death.

Based on the beta-blockers are effective for control of ventricular arrhythmias and ventricular
premature beats.

Dosage[10]
Hypertension
Adult: 25-50 mg/day orally initially; may be increased to 100 mg/day orally
Pediatric (Off-label): 0.5-1 mg/kg/day orally; not to exceed 2 mg/kg/day or 100 mg/day
Geriatric: 25 mg/day orally initially; may be increased to 100 mg/day orally

Angina Pectoris
Adult: 50 mg/day orally; after 1 week, may be increased to 100 mg/day orally; some patients
may require 200 mg/day

Geriatric: 25 mg/day orally; after 1 week, may be increased to 100 mg/day; some patients
may require 200 mg/day

Post myocardial infarction (MI)

Secondary prevention
Adult: 100 mg orally once daily or divided every 12 hours for 6-9 days after myocardial
infarction (MI)

Geriatric: 100 mg orally once daily or divided every 12 hours for 6-9 days after MI

Alcohol withdrawal syndrome (off-label)

50-100 mg/day orally

www.wjpps.com Vol 9, Issue 3, 2020. 907

Ajesh. World Journal of Pharmacy and Pharmaceutical Sciences

Supraventricular arrhythmias (off-label)

Prevention
50 mg/day orally, beginning up to 3 days before surgery and continued until 7 days after
surgery; may be increased to 100 mg/day

Thyrotoxicosis (off-label)
25-100 mg orally once daily or divided every 12 hours

Dosage forms
Tenormin is available in 25, 50 and 100 mg strength tablets; it is also available vials of 5 mg
atenolol in ten ml of citrate-buffered solution for intravenous injection. The IV preparation
should only be administered by trained personnel. The usual dose for tablets begins at 25 mg
once or twice per day and is modified by patient response to the medication. The following
information applies to both the tablet and IV forms of atenolol.

Side effects[3,4]
Atenolol has been well tolerated by most patients. Overall profile of adverse effects of
atenolol generally resembles that of propranolol, although a smaller proportion of patients has
discontinued treatment with atenolol (2.2% versus 9.7%).

It can also cause side effects which are-

More common side effects

The more common side effects of atenolol can include:

• cold hands and feet

• constipation

• diarrhoea

• dizziness

• headache

• reduced sex drive or impotence

• shortness of breath

• unexplained tiredness

• leg pain

www.wjpps.com Vol 9, Issue 3, 2020. 908

Ajesh. World Journal of Pharmacy and Pharmaceutical Sciences

• blood pressure that’s lower than usual

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re
more severe or don’t go away, then there is need of doctor’s or pharmacist’s help.

Serious side effects

Serious side effects of Atenolol and their symptoms can include the following
 Allergic reaction. Symptoms can include:
 a large, red rash
 fever
 swelling of the hands, feet, and ankles
 swelling of your throat or tongue
 trouble breathing
 Depression. Symptoms can include:
 feelings of sadness or hopelessness
 anxiety
 tiredness
 trouble focusing
 Unusual weight gain. Symptoms can include:
 swelling of the feet, ankles, or arms

Atenolol can however, be given with caution to those with obstructive airways disease,
provided full doses of a β2-agonist bronchodilator are given at the same time. Although a
single case of retroperitoneal fibrosis has been reported in a patient receiving atenolol, a
causal relationship was not clearly established.

Atenolol in pregnency
The FDA classifies Atenolol as a Pregnancy Category D medication which means that it can
cause harm on the unborn child when used during pregnancy. Atenolol passes the placenta
which exposes the fetus to possible negative effects. In addition, some studies have shown
that taking Atenolol during second trimester of pregnancy results in infants that are smaller
for gestational age and with lower birth weight. Fetal exposure to Atenolol during the last
months of pregnancy increases the infant’s risk . Slow heart rate (bradycardia), Low blood
sugar (hypoglycemia) and Low blood pressure (hypotension) immediately or several hours
after delivery.

www.wjpps.com Vol 9, Issue 3, 2020. 909

Ajesh. World Journal of Pharmacy and Pharmaceutical Sciences

Atenolol is not recommended for breastfeeding women. This medication is excreted in the
human milk and can cause unwanted effects on the nursing infant.

Atenolol tends to accumulate in the breast milk. Clinical studies reveal that breast milk
contains Atenolol at a ratio of 1.5 to 6.8 when compared to drug levels in plasma.

Precautions
Cardiac failure
Sympathetic stimulation is necessary in supporting circulatory function in congestive heart
failure, and beta blockade carries the potential hazard of further depressing myocardial
contractility and precipitating more severe failure.

In patients with acute myocardial infarction, cardiac failure, which is not promptly and
effectively controlled by 80 mg of intravenous furosemide or equivalent therapy, is a
contraindication to beta blocker treatment.

In patients without a history of cardiac failure

Continued depression of the myocardium with beta-blocking agents over a period of time
can, in some cases, lead to cardiac failure. At the first sign or symptom of impending cardiac
failure, patients should be treated appropriately according to currently recommended
guidelines, and the response observed closely. If cardiac failure continues despite adequate
treatment, atenolol should be withdrawn.

Cessation of Therapy with atenolol

Patients with coronary artery disease, who are being treated with atenolol, should be advised
against abrupt discontinuation of therapy. Severe exacerbation of angina and the occurrence
of myocardial infarction and ventricular arrhythmias have been reported in angina patients
following the abrupt discontinuation of therapy with beta blockers. The last two
complications may occur with or without preceding exacerbation of the angina pectoris. As
with other beta blockers, when discontinuation of atenolol is planned, the patients should be
carefully observed and advised to limit physical activity to a minimum. If the angina worsens
or acute coronary insufficiency develops, it is recommended that atenolol be promptly
reinstituted, at least temporarily. Because coronary artery disease is common and may be
unrecognized, it may be prudent not to discontinue atenolol therapy abruptly even in patients
treated only for hypertension.

www.wjpps.com Vol 9, Issue 3, 2020. 910

Ajesh. World Journal of Pharmacy and Pharmaceutical Sciences

Concomitant use of calcium channel blockers

Bradycardia and heart block can occur and the left ventricular end diastolic pressure can rise
when beta blockers are administered with verapamil or diltiazem. Patients with preexisting
conduction abnormalities or left ventricular dysfunction are particularly susceptible.

Bronchospastic diseases
Patients with bronchospastic disease should not, in general, not receive beta blockers.
Because of its relative beta 1 selectivity, however, atenolol may be used with caution in
patients with bronchospastic disease who do not respond to, or cannot tolerate, other
antihypertensive treatment. Since beta 1 selectivity is not absolute, the lowest possible dose
of atenolol should be used with therapy initiated at 50 mg and a beta 2- stimulating agent
(bronchodilator) should be made available. If dosage must be increased, dividing the dose
should be considered in order to achieve lower peak blood levels.

Major surgery
Chronically administered beta-blocking therapy should not be routinely withdrawn prior to
major surgery; however the impaired ability of the heart to respond to reflex adrenergic
stimuli may augment the risks of general anesthesia and surgical procedures.

Diabetes and hypoglycemia

Atenolol should be used with caution in diabetic patients if a beta-blocking agent is required.
Beta blockers may mask tachycardia occurring with hypoglycemia, but other manifestations
such as dizziness and sweating may not be significantly affected. At recommended doses
atenolol does not potentiate insulin-induced hypoglycemia and, unlike nonselective beta
blockers, does not delay recovery of blood glucose to normal levels.

Thyrotoxicosis
Beta-adrenergic blockade may mask certain clinical signs (e.g., tachycardia) of
hyperthyroidism. Abrupt withdrawal of beta blockade might precipitate a thyroid storm;
therefore, patients suspected of developing thyrotoxicosis from whom atenolol therapy is to
be withdrawn should be monitored closely.

Untreated Pheochromocytoma
Atenolol should not be given to patients with untreated pheochromocytoma.

www.wjpps.com Vol 9, Issue 3, 2020. 911

Ajesh. World Journal of Pharmacy and Pharmaceutical Sciences

Drug interactions[11, 12, 13,14]

Atenolol and alcohol (ethanol)
Atenolol and ethanol may have additive effects in lowering your blood pressure. You may
experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart
rate. These side effects are most likely to be seen at the beginning of treatment, following a
dose increase, or when treatment is restarted after an interruption. Let your doctor know if
you develop these symptoms and they do not go away after a few days or they become
troublesome. Avoid driving or operating hazardous machinery until you know how the
medications affect you, and use caution when getting up from a sitting or lying position. It is
important to tell your doctor about all other medications you use, including vitamins and
herbs. Do not stop using any medications without first talking to your doctor.

Atenolol and multivitamins with minerals

Using atenolol together with multivitamin with minerals may decrease the effects of atenolol.
Separate the administration times of atenolol and multivitamin with minerals by at least 2
hours. If your doctor does prescribe these medications together, you may need a dose
adjustment or special test to safely use both medications. It is important to tell your doctor
about all other medications you use, including vitamins and herbs. Do not stop using any
medications without first talking to your doctor.

Atenolol and food

You may take atenolol with or without food, but take it the same way every time. Avoid
consumption of large amounts of orange juice to prevent any changes in your atenolol levels.
Orange juice could decrease the effectiveness of atenolol.

High Cholesterol (Hyperlipoproteinemia, Hypertriglyceridemia, Sitosterolemia)

Beta-adrenergic receptor blocking agents (aka beta-blockers) may alter serum lipid profiles.
Increases in serum VLDL and LDL cholesterol and triglycerides, as well as decreases in
HDL cholesterol, have been reported with some beta-blockers. Patients with preexisting
hyperlipidemia may require closer monitoring during beta-blocker therapy, and adjustments
made accordingly in their lipid-lowering regimen.

www.wjpps.com Vol 9, Issue 3, 2020. 912

Ajesh. World Journal of Pharmacy and Pharmaceutical Sciences

Table 1: Atenolol is known to interact with other drugs, the details of drug interactions
is as follows.

Minor Moderate Major Severity

Diazepam Adrenaline Prazosin Amlodipine (Besylate)
Diltiazem (HCl) Alfuzosin Indacaterol
Digoxin Clonidine (HCl) Aldesleukin
Verapamil (HCl) Naphazoline
Nifedipine Flurbiprofen
Metformin (HCl) Lacidipine
Thioridazine (HCl) Amiodarone (HCl)
Disopyramide
Indomethacin

CONCLUSION
From the above discussion it is concluded that atenolol is very important drug for the
treatment of several disease. Atenolol belongs to beta blocker class of drugs. It is one of the
most commonly prescribed betablocker all over the world. Atenolol is a cardioselective β-
blocker, selective β1 adrenergic antagonist. Atenolol was first introduced in 1976 and has

been approved by the US FDA from August 1981 as a therapeutic agent for both
hypertension and coronary artery disease. Since itis more prescribed it have low
bioavailability which is the major problem in the action of atenolol. Which will be modified
by several methods.

REFERENCES
1. Raghavendra Kumar Gunda, J. N. Suresh Kumar, Chandan Kumar Brahma, V.
Satyanarayana, K. Naga Prashant, Design, Formulation and Evaluation of Atenolol
Gastro Retentive Floating Tablets , Asian Journal of Pharmaceutics, 2015; 9(4): 34- 42.
2. Radha Rani Earle, Lakshmi Usha. Ayalasomayajula, P. Venkatesh, P. Ganapathi Naidu,
S. Vidya Sagar, Bhagya Sree Vani, Formulation and evaluation of atenolol orodispersable
tablets by co-processed super-disintegration process, International Journal of Advances in
Pharmaceutics, 2016; 5(2): 46-51.

www.wjpps.com Vol 9, Issue 3, 2020. 913

Ajesh. World Journal of Pharmacy and Pharmaceutical Sciences

3. R. C. Heel, R. N. Brogden, T. M. Speight, G. S. Avery, Atenolol: A Review of its

Pharmacological Properties and Therapeutic Efficacy in Angina Pectoris and
Hypertension, June, 1979; 17(6): 425–460.
4. Atenolol, Oral Tablet Medically reviewed by University of Illinois-Chicago, Drug
Information Group on January. Written by University of Illinois-Chicago, Drug
Information Group, 2018; 12.
5. Bangalore S, Messerli FH, Kostis Jb etal cardiovascular protection using betablockers: J
Am coll cardiol, 2007; 50: 563-572.
6. Chrysant SG, chrysant GS, dumas b current and future study of betablockers in treatment
of Hypertension, clin cardiol, 2008; 31(6): 249-252.
7. Gurpreet Singh Wander, Shibba Takkar Chhabra, Kaza Kaur, Atenolol drug Profile,
JAPI, 2009; 57: 13-16.
8. World Health Organisation, Revision of the monograph on Atenolol, Working document,
2017; 3(5): 17-700.
9. Day JL, Metcalf J, Simpson cN. Adrenergic mechanisms in control of plasma lipid
concentrations. Bmj, 1982; 284: 1145 – 1148.
10. https://www.rxlist.com/consumer_atenolol_tenormin/drugs-condition.htm# (2019;3:24)
11. https://www.drugs.com/ppa/atenolol.html (2019;3:24)
12. R. C. HeelR. N. BrogdenT. M. Speight G. S. Avery, Atenolol: A Review of its
Pharmacological Properties and Therapeutic Efficacy in Angina Pectoris and
Hypertension, 1979; 17(6): 425–460.
13. Samuel P, Chin B, Schoenfeld BH, et al "Comparison of the effect of pindolol versus
propranolol on the lipid profile in patients treated for hypertension." Br J Clin Pharmacol,
1987; 24: s63-4.
14. Gordon NF, Scott CB, Duncan JJ "Effects of atenolol versus enalapril on cardiovascular
fitness and serum lipids in physically active hypertensive men." Am J Cardiol, 1997; 79:
1065-9.

www.wjpps.com Vol 9, Issue 3, 2020. 914