Atenolol use and the re-accurance of arrythmia

[Willard]

I am 45 years old and on atenolol for High blood pressure. I have been on this medication for about 2 months 50 mg 1 time each day. This seems to have helped the high blood pressure pretty well and my pvc's and arrythmias seem to have almost entirely gone away thats up until about 1 week ago..I had a real bad night! I believe I may have been in a-fib for awhile then pvc's real bad for about 1-1/2 hours, then it just stabalized and I was able to sleep. But the  last week I have ..almost every night, had pvc's many in a row, and very fast heart rates 110-170 or so for short bursts then things would calm down for awhile then back to it again ...this happens all night long... My question is did my body build a  tolerance to Atenelol? Or do I need my dosage changed or just what might have happened? Please advise as I can't sleep very well at night! Thanks

[CCF-M.D.-CRC]

Dear willard,
There can be some tolerance that develops to beta-blockers and your doctor may wish to increase your dose after he hears about your symptoms.  Also a Holter monitor test to document what type of arrhythmias you are having is probably a good idea.  I would call your doctor or make an appointment with him/her to discuss these issues.

[WJS]

Atenolol is probably not the best choice for BP control only, but is probably prescribed because it's cheap and sometimes effective.  It does affect the autonomic system, however, and that's not always good.

I had to get off of Atenolol because it cause Vasal-Vagal Syncope Episodes.

I would suggest that you ask for a newer ACE inhibitor such as ALTACE or Zestril for BP control.

[Barbara]

Hi Willard:  Just read your comment about atenolol.  I take atenolol twice a day 50mg both times.  Once in the morning and once in the evening.  In between I take 150mg of Avapro.  These are supposed to be for blood pressure.  Also I get heart skips all the time.  Been through so many tests.  I never thought that just maybe I'm on too much medication.  I questioned my cardiologist about this and he said I'm doing fine.  Go figure.  Barbara

[WJS]

I can't imagine taking 100 mg of Atenolol per day.  They started me on 50 and it really pulled me down physically.  I cut back to 25 and cut that pill in half, taking half in the morning and half in the evening.

I am not a fan of Atenolol, especially for physically active people.  It might be a good drug for a few month's after having a heart attack, because it lessens the load on the heart.

I think that the drug is prescribed many times because its patent has expired and it's cheap.  It is effective against high blood pressure and may help with arrythmias, but I don't believe that it's substantial side effects are considered enough by doctors.

If it's just a matter of blood pressure, I have had a much better experience with low doses of the ACE inhibitor ALTACE in combination with the CCB, Norvasc.

ACE inhibitors have proven to have other beneficial effects against heart failure and in combination with statins for lipid management also.  I also found that ALTACE eliminated the occasional episodes of PVCs or PACs that I had, although it's not prescribed for that.