{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:32:21Z","timestamp":1772253141519,"version":"3.50.1"},"reference-count":42,"publisher":"Sociedade Brasileira de Cardiologia","issue":"9","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Bras. Cardiol."],"abstract":"<jats:p>Resumo  Fundamento  A hipertens\u00e3o arterial (HA) \u00e9 um problema global de sa\u00fade p\u00fablica, com alta preval\u00eancia e impacto significativo na morbimortalidade cardiovascular. Betabloqueadores cardiosseletivos, como o atenolol, s\u00e3o amplamente utilizados no tratamento da HA, mas sua indica\u00e7\u00e3o como terapia de primeira linha \u00e9 controversa.  Objetivos  Avaliar a efic\u00e1cia e a seguran\u00e7a do atenolol no tratamento da HA prim\u00e1ria, em compara\u00e7\u00e3o com outras classes de medicamentos anti-hipertensivos de primeira escolha.  M\u00e9todos  Foi realizada uma revis\u00e3o sistem\u00e1tica com base em uma pergunta estruturada no formato PICO. Foram inclu\u00eddos ensaios cl\u00ednicos randomizados que compararam o atenolol com outros anti-hipertensivos. A busca foi conduzida em tr\u00eas bases de dados internacionais. A qualidade metodol\u00f3gica foi avaliada por meio da ferramenta RoB 2, e a certeza da evid\u00eancia, pelo sistema GRADE. O desfecho prim\u00e1rio composto foi a ocorr\u00eancia de eventos cardiovasculares maiores. Desfechos secund\u00e1rios inclu\u00edram mortalidade por todas as causas, infarto do mioc\u00e1rdio e acidente vascular cerebral, analisados separadamente.  Resultados  Sete ensaios cl\u00ednicos atenderam aos crit\u00e9rios de inclus\u00e3o. Em compara\u00e7\u00e3o com anlodipino e losartana, o atenolol apresentou incid\u00eancia discretamente maior de eventos cardiovasculares, com certeza da evid\u00eancia baixa e moderada, respectivamente. A combina\u00e7\u00e3o de hidroclorotiazida e amilorida demonstrou maior redu\u00e7\u00e3o de eventos cardiovasculares em rela\u00e7\u00e3o ao atenolol, embora com certeza da evid\u00eancia muito baixa. A redu\u00e7\u00e3o da press\u00e3o arterial (PA) foi semelhante entre os medicamentos comparados.  Conclus\u00f5es  Apesar das limita\u00e7\u00f5es das evid\u00eancias dispon\u00edveis, o atenolol demonstrou efic\u00e1cia semelhante na redu\u00e7\u00e3o da PA, com pequenas diferen\u00e7as em desfechos cardiovasculares, favorecendo outras classes de anti-hipertensivos. Sua prescri\u00e7\u00e3o pode ser considerada entre as op\u00e7\u00f5es de associa\u00e7\u00e3o medicamentosa no tratamento da HA prim\u00e1ria em adultos. Outros betabloqueadores n\u00e3o foram avaliados nesta revis\u00e3o sistem\u00e1tica.<\/jats:p>","DOI":"10.36660\/abc.20250034","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T18:06:33Z","timestamp":1760465193000},"source":"Crossref","is-referenced-by-count":0,"title":["Revis\u00e3o Sistem\u00e1tica Sobre a Efic\u00e1cia do Atenolol no Tratamento Anti-Hipertensivo: Recomenda\u00e7\u00e3o da Sociedade Brasileira de Cardiologia"],"prefix":"10.36660","volume":"122","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7040-396X","authenticated-orcid":false,"given":"Andr\u00e9a Araujo","family":"Brand\u00e3o","sequence":"first","affiliation":[{"name":"Universidade do Estado do Rio de Janeiro,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9490-7997","authenticated-orcid":false,"given":"Cibele Isaac Saad","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Pontif\u00edcia Universidade Cat\u00f3lica de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilson","family":"Nadruz","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5333-013X","authenticated-orcid":false,"given":"Paulo Cesar B","family":"Veiga Jardim","sequence":"additional","affiliation":[{"name":"Universidade Federal de Goi\u00e1s,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2311-4222","authenticated-orcid":false,"given":"Fernando","family":"Nobre","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0904-8564","authenticated-orcid":false,"given":"Sergio Emanuel","family":"Kaiser","sequence":"additional","affiliation":[{"name":"Universidade do Estado do Rio de Janeiro,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Otavio Rizzi","family":"Coelho","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3220-019X","authenticated-orcid":false,"given":"Fernanda Marciano Consolim","family":"Colombo","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9901-6421","authenticated-orcid":false,"given":"Leonardo Castro","family":"Luna","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cardiologia,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andressa","family":"Braga","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cardiologia,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quenia Dias","family":"Morais","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cardiologia,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4865-6442","authenticated-orcid":false,"given":"Luiz","family":"Bortolotto","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"22636","published-online":{"date-parts":[[2025]]},"reference":[{"key":"ref1","series-title":"Global Brief on Hypertension: Silent Killer, Global Public Health Crisis","year":"2021"},{"key":"ref2","article-title":"Prevalence of Arterial Hypertension According to Different Diagnostic Criteria, National Health Survey","volume":"21","author":"Malta DC","year":"2018","journal-title":"Rev Bras Epidemiol"},{"issue":"3","key":"ref3","first-page":"516","article-title":"Brazilian Guidelines of Hypertension - 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