Does atenolol improve physical and psychological function after coronary artery bypass surgery: A controlled study

doi:10.1016/0022-3999(87)90010-9

Journal of Psychosomatic Research

Volume 31, Issue 4, 1987, Pages 521-529

https://doi.org/10.1016/0022-3999(87)90010-9 Get rights and content

Abstract

A double-blind prospective randomized trial of atenolol (100 mg once daily) was carried out on 88 patients (78 men) awaiting coronary artery bypass graft surgery. Standardized ratings of both psychiatric morbidity and functional capacity were made before, 3 months (n = 82) and 12 months (n = 81) after surgery. One year after surgery men in the atenolol group had a significantly shorter treadmill exercise time than those on placebo (7.21 ± 0.28 min vs 8.32 ± 0.40 min; p < 0.05), but the frequency of reported anginal attacks during the year was similar in both drug groups. Improvement in functional capacity (measured in exercise time) in the 71 men following surgery was related to both physical and psychological variables assessed before the operation. Men with more severe occlusive disease, lower neuroticism and higher extraversion scores pre-operatively showed greater percentage improvement in exercise time after surgery. Women had significantly higher levels of psychiatric morbidity and shorter treadmill exercise time than men both before and after surgery.

Of the psychiatric and psychological variables, only ratings of Type A behaviour fell significantly in the atenolol group (170.9 ± 5.3 vs 163.0 ± 5.2; p < 0.05). This change, which is probably not clinically important, occurred independently of any reduction in either overall psychiatric morbidity score or ratings of somatic symptoms mediated by beta-adrenergic receptors. The atenolol group reported more side-effects of both psychological and physical symptoms than the placebo group.

We do not recommend the routine use of atenolol after bypass graft surgery. Our findings failed to support the suggestion that Type A characteristics may reflect an underlying sympathetic nervous system reactivity.

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Does atenolol improve physical and psychological function after coronary artery bypass surgery: A controlled study

Abstract

Lancet

Am Heart J

J Chron Dis

Lancet

Lancet

Ann Thorac Surg

Timolol-induced reduction in mortality and reinfarction in patients surviving acute myocardial infarction

N Eng J Med

Propranolol medication among coronary patients: relationship to type A behaviour and cardiovascular response

J Hum Stress

The influence of beta blockers on cardiovascular reactivity and type A behaviour pattern in hypertensives

Psychosom Med

A standardized interview for use in community surveys

Br J Prev Soc Med

A self-rating scale of distress

Psychol Med