Bisoprolol 10mg / Hydrochlorothiazide 6.25mg tablets

BackgroundHypertension (HTN) is a global public health issue, with high prevalence and a significant impact on cardiovascular morbidity and mortality. Cardioselective beta-blockers, such as atenolol, are widely used in the treatment of HTN, although their indication as first-line therapy remains controversial.ObjectiveTo evaluate the efficacy and safety of atenolol in the treatment of primary HTN, compared with other first-line classes of antihypertensive drugs.MethodsA systematic review was conducted based on a research question structured using the PICO format. Randomized clinical trials comparing atenolol with other antihypertensive agents were included. Searches were performed in three international databases. Methodological quality was assessed using the RoB 2 tool, and the certainty of evidence was rated using the GRADE system. The primary composite outcome was the occurrence of major cardiovascular events. Secondary outcomes included all-cause mortality, acute myocardial infarction, and stroke, each analyzed separately.ResultsSeven clinical trials met the inclusion criteria. Compared with amlodipine and losartan, atenolol was associated with a slightly higher incidence of cardiovascular events, with low and moderate certainty of evidence, respectively. The combination of hydrochlorothiazide and amiloride demonstrated a greater reduction in cardiovascular events compared to atenolol, although with very low certainty of evidence. Blood pressure (BP) reduction was similar across the compared treatments.ConclusionsDespite the limitations of available evidence, atenolol showed comparable efficacy in BP reduction, with small differences in cardiovascular outcomes favoring other antihypertensive classes. Its use may be considered among the options for combination therapy in the treatment of primary HTN in adults. Other beta-blockers were not evaluated in this systematic review.

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BackgroundFemale sexual dysfunction (FSD) among females with hypertension (HTN) is frequently overlooked, with a reported prevalence of 42.1%.ObjectivesWe aimed to determine the impact of beta-blockers (BBs), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs), and thiazides on sexual function in hypertensive females.MethodsA prospective randomized controlled trial enrolled 125 female participants. Group (1) included 25 normotensive females serving as the controls. Groups (2) and (3) consisted of 50 controlled and uncontrolled hypertensive patients who received BBs, respectively. Groups (4) and (5) consisted of 50 patients with controlled and uncontrolled HTN who received ACIs/ARBs, respectively. Each group consisted of patients who received one tablet daily of ramipril 2.5 mg for one month, while the other half received one tablet daily of valsartan (VAL) 80 mg for the same duration. After one month, the subjects were transitioned to a daily regimen of one tablet of ramipril 2.5 mg combined with hydrochlorothiazide 12.5 mg, as well as one tablet of VAL 80 mg with hydrochlorothiazide 12.5 mg for two months, respectively.ResultsControlled and uncontrolled hypertensive patients receiving ACEIs/ARBs, as well as controlled hypertensive patients receiving BBs, demonstrated a significant decrease in serum total testosterone and free testosterone levels, accompanied by a significant increase in estradiol after 3 months. Furthermore, controlled and uncontrolled hypertensive patients receiving ACEI/ARBs showed significant increases in all female sexual function (FSF) domains and total FSF scores after 3 months. Consistently, controlled hypertensive patients receiving BBs showed significant improvements across all domains of the validated Arabic version of the female sexual function index (ArFSFI) and the total score, comparable to the ACEI/ARB groups, except for pain. Conversely, uncontrolled hypertensive patients receiving BBs demonstrated significant increases in scores for desire and arousal and orgasm and satisfaction after 3 months. After three months, there was a significant reduction in the GAD-7 scores among all hypertensive patients.ConclusionACEIs/ARBs demonstrated a favorable effect on FSF. Future large-scale cohort studies are warranted to validate these findings as this study was a single center and of small sample size.

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