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atenolol vs metoprolol

Posted by mike99 on April 17, 2006, at 21:23:23

I have a few questions regarding differences between the two if anyone would care to answer.

Here is what I understand the differences between atenolol and metoprolol to be (please correct me if I'm wrong):

While both are cardioselective, atenolol tends to lose this selectivity much more easily than metoprolol at increased doses.

Metoprolol is more liphophilic--so it penetrates the brain more easily and therefore may be more likely to cause sedation/depression/cognitive problems than atenolol.

Metoprolol: the only beta blocker proven for treatment of angina, high blood pressure and heart failure. I also found an article called "Time to Reconsider Atenolol?" suggesting atenolol may not have many other cardioprotective benefits which metoprolol possesses.

Atenolol: Not metabolized by liver, longer acting
Metoprolol: Metabolized by liver, shorter acting

Are there any other significant differences I should know about (perhaps in terms of ED, lipid effects, insulin resistance, exercise tolerance...others)? Is tolerance or dose escalation more likely with one than the other?

It seems atenolol may have the upper hand in terms of CNS effects but metoprolol may be better on the whole for the heart???

OK I will stop with the million questions. Just wondering if there are any important differences of which I should be aware. I'd greatly appreciate any feedback. Peace out.




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