REVIEW Like metoprolol, atenolol competes with sympathomimetic neurotransmitters such as catecholamines for binding at beta(1)-adrenergic receptors in the heart and vascular smooth muscle, inhibiting sympathetic stimulation. This results in a reduction in resting heart rate, cardiac output, systolic and diastolic blood pressure, and reflex orthostatic hypotension. Higher doses of atenolol also competitively block beta(2)-adrenergic responses in the bronchial and vascular smooth muscles.
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Carlberg B, Samuelsson O, Lindholm LH (2004). Atenolol in hypertension: is it a wise choice?. Lancet 364 (9446): 1684-9. doi:10.1016/S0140-6736(04)17355-8. PMID 15530629.
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