Effect of Anti-Hypertensive Drug Atenolol on Liver Function by Evaluating ALT levels : Drug Atenolol on Liver Function by Evaluating ALT levels

Maria Fareed Siddiqui; Mehreen Rasheed; Ahmad Alwazzan; Sadia  Sarwar

doi:10.54393/fbt.v3i01.36

Authors

Maria Fareed Siddiqui Faculty of Pharmacy, The University of Lahore, Lahore, Pakistan
Mehreen Rasheed Faculty of Pharmacy, The University of Lahore, Lahore, Pakistan
Ahmad Alwazzan Department of Obstetrics and Gynecology, King Abdul Aziz University, Jeddah, Saudi Arabia
Sadia Sarwar Lahore College for Women University, Lahore, Pakistan

DOI:

https://doi.org/10.54393/fbt.v3i01.36

Keywords:

ALT level, Hypertension, Atenolol

Abstract

Hypertension is one of the major causes of cardiovascular and renal pathologies and it is mainly characterized by high blood pressure in blood vessels. Many drugs have been developed to treat hypertension, but these drugs have several side effects. Atenolol belongs to the beta blocker drug class and is used to treat hypertension and cardiovascular diseases. It is an anti-beta-adrenergic agent which inhibits beta receptors in the heart to decrease blood pressure. It has several side effects including hepatic dysfunctions. Objective: To analyze the effects of atenolol on hepatic dysfunction by evaluating the ALT level in patients taking either atenolol alone or in combination with other hypertensive drugs. Methods: The change in ALT levels were measured upon treatment of atenolol alone or in combination with other anti-hypertensive drugs. Out of selected 80 patients, 43 had been taking atenolol alone, 37 were taking atenolol in combination with other anti-hypertensive drugs and 20 were healthy controls. Micro-laboratory tests were performed for measuring the ALT levels. Results: Atenolol did not affect the ALT levels of any group, neither alone nor in combination with other hypertensive drugs. Conclusions: Atenolol may cause hepatic dysfunction but according to this study it does not cause change in ALT level of blood and ALT is not elevated in all liver dysfunction as have been reported earlier so it didn’t diminish the chance of effect of atenolol on liver functions. Further this study may be employed on larger patient groups for strengthening the outcomes of this study.

References

Kario K. Obstructive sleep apnea syndrome and hypertension: ambulatory blood pressure. Hypertension Research. 2009 Jun; 32(6): 428-32. doi: 10.1038/hr.2009.56.

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al., The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. Jama. 2003 May; 289(19) :2560-71. doi: 10.1001/jama.289.19.2560.

Havlik RJ, Garrison RJ, Feinleib M, Kannel WB, Castelli WP, Mcnamara PM. Blood pressure aggregation in families. American Journal of Epidemiology. 1979 Sep; 110(3): 304-12. doi: 10.1093/oxfordjournals.aje.a112815.

Hamet P, Pausova Z, Adarichev V, Adaricheva K, Tremblay J. Hypertension: genes and environment. Journal of Hypertension. 1998 Apr; 16(4): 397-418. doi: 10.1097/00004872-199816040-00001.

Somers VK, Dyken ME, Mark AL, Abboud FM. Sympathetic-nerve activity during sleep in normal subjects. New England Journal of Medicine. 1993 Feb; 328(5): 303-7. doi: 10.1056/NEJM199302043280502.

Mark AL. The sympathetic nervous system in hypertension: a potential long-term regulator of arterial pressure. Journal of hypertension. Supplement: official journal of the International Society of Hypertension. 1996 Dec; 14(5): 159-65.

Esler M. The sympathetic system and hypertension. American Journal of Hypertension. 2000 Jun; 13(S4): 99S-105S. doi: 10.1016/S0895-7061(00)00225-9.

Messerli FH and Nussberger J. Vasopeptidase inhibition and angio-oedema. The Lancet. 2000 Aug; 356(9230): 608-9. doi: 10.1016/S0140-6736(00)02596-4.

Cushman WC, Ford CE, Cutler JA, Margolis KL, Davis BR, Grimm RH, et al. Original Papers. Success and predictors of blood pressure control in diverse North American settings: the antihypertensive and lipid‐lowering treatment to prevent heart attack trial (ALLHAT). The Journal of Clinical Hypertension. 2002 Nov; 4(6): 393-404.

Agon P, Goethals P, Van Haver D, Kaufman JM. Permeability of the blood‐brain barrier for atenolol studied by positron emission tomography. Journal of Pharmacy and Pharmacology. 1991 Aug; 43(8): 597-600. doi: 10.1111/j.2042-7158.1991.tb03545.x.

Kulcsar-Gergely J, Posan E, Kulcsar A. Metabolic actions of a single atenolol and metoprolol dose. Arzneimittel-forschung. 1994 Nov; 44(11): 1183-5.

Gowda S, Desai PB, Hull VV, Avinash AK, Vernekar SN, Kulkarni SS. A review on laboratory liver function tests. The Pan African Medical Journal. 2009 Nov; 3: 17.

Zusman RM, Prisant LM, Brown MJ, Sildenafil Study Group. Effect of sildenafil citrate on blood pressure and heart rate in men with erectile dysfunction taking concomitant antihypertensive medication. Journal of Hypertension. 2000 Dec; 18(12): 1865-9. doi: 10.1097/00004872-200018120-00022.

Nyblom H, Berggren U, Balldin J, Olsson R. High AST/ALT ratio may indicate advanced alcoholic liver disease rather than heavy drinking. Alcohol and Alcoholism. 2004 Jul; 39(4): 336-9. doi: 10.1093/alcalc/agh074.

Liu Z, Que S, Xu J, Peng T. Alanine aminotransferase-old biomarker and new concept: a review. International Journal of Medical Sciences. 2014; 11(9): 925. doi: 10.7150/ijms.8951.

Mondal MK, Nessa A, Khatun N. Study of Body Mass Index, Blood Pressure, Serum Sodium in Newly Diagnosed Hypertensive Patients. Mymensingh Medical Journal. 2023 Apr; 32(2): 355-60.

Brunström M, Brunström A, Jussil H, Panagiotopoulou K, Chaimani A, Carlberg B. Comparative efficacy and acceptability of different antihypertensive drug classes for cardiovascular disease prevention: a systematic review and network meta-analysis. Journal of Hypertension. 2023 Jun; 41(1): e78-9. doi: 10.1097/01.hjh.0000939516.35507.91.

Shan Y, Cheung L, Zhou Y, Huang Y, Huang RS. A systematic review on sex differences in adverse drug reactions related to psychotropic, cardiovascular, and analgesic medications. Frontiers in Pharmacology. 2023; 14. doi: 10.3389/fphar.2023.1096366.

Dumortier J, Guillaud O, Gouraud A, Pittau G, Vial T, Boillot O, et al. Atenolol hepatotoxicity: report of a complicated case. Annals of Pharmacotherapy. 2009 Oct; 43(10): 1719-23. doi: 10.1345/aph.1M247.

Jeeyavudeen MS, Khan SK, Fouda S, Pappachan JM. Management of metabolic-associated fatty liver disease: The diabetology perspective. World Journal of Gastroenterology. 2023 Jan; 29(1): 126. doi: 10.3748/wjg.v29.i1.126.

Pettersson J, Hindorf U, Persson P, Bengtsson T, Malmqvist U, Werkström V, et al. Muscular exercise can cause highly pathological liver function tests in healthy men. British Journal of Clinical Pharmacology. 2008 Feb; 65(2): 253-9. doi: 10.1111/j.1365-2125.2007.03001.x.