Withdrawal of long-term therapy with atenolol in hypertensive patients.

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Abstract
1 The offset of effects on blood pressure and heart rate after cessation of long‐term therapy (19 +/‐ 3.6 months) with atenolol (200 mg once/daily) was studied in six hypertensive patients. 2 Withdrawal of atenolol resulted in a gradual return of lying, standing and post‐ exercise systolic and diastolic blood pressure levels and heart rate towards the baseline value. The offset of effect greatly exceeded the time for elimination of atenolol. 3 No significant differences in the pharmacokinetic profile of atenolol were evident between the values obtained following chronic dosing and an acute single‐dose study. 4 The lack of clinical evidence of increased cardiac adrenergic sensitivity or rebound hypertension following withdrawal of atenolol contrasts with reports of a withdrawal syndrome following cessation of therapy with propranolol. Nevertheless until the mechanism of the propranolol‐ withdrawal syndrome is better understood caution is required when stopped therapy with atenolol in patients with severe coronary artery disease.