Metoprolol versus Atenolol
Both atenolol and metoprolol are beta-blockers used to treat hypertension. Both drugs are beta-1 selective, implying their significantly higher action than other medications. As seen below, the drugs have notable differences in indications, efficacy, and dosing despite being used to treat heart disease.
Indications
Both atenolol and metoprolol are indicated for the treatment of hypertension. While both drugs are beta-blockers, metoprolol acts by blocking the action of the sympathetic nervous system while atenolol blocks the effects of adrenaline and epinephrine, which are also released by the sympathetic nervous system (Parker et al., 2012). The drugs block the stimulation of these nerves, thus preventing the heart from beating rapidly by reducing the heart rate and the force of contraction of heart muscles. This, in turn, lowers blood pressure.
Dosing
Metoprolol and atenolol have different dosage prescriptions. A dosage of 100 to 450 mg daily is recommended when using metoprolol to treat hypertension. On the contrary, treating hypertension using atenolol requires a daily dosage of 25 to 100 mg. While both drugs require 2 mg dosages to treat acute myocardial infarction, metoprolol and atenolol should be administered at different intervals of 2 minutes and 10 minutes, respectively (Parker et al., 2012). Besides, atenolol is only available as an oral tablet whereas metoprolol is available as an oral tablet, an oral solution, and an intravenous solution.
Efficacy
In a randomized study on the effectiveness of metoprolol and atenolol conducted on patients having primary hypertension, atenolol was more effective than metoprolol. However, both drugs managed the condition by lowering the blood pressure of patients, as compared to placebo. The higher efficacy of atenolol was particularly evident 25 hours after the dosing (Ram & Venkata, 2010).
Recommendation
I would choose atenolol over metoprolol as the drug for treating hypertension without other clinical considerations. Atenolol’s greater efficacy influences this choice over metoprolol because it has a longer effect of lowing the blood pressure than metoprolol.