1. The effect of the cardioselective β-adrenoreceptor antagonist atenolol on blood pressure, heart rate, systolic time interval, limb blood flow and limb vascular resistance was studied, both when the drug was used by itself, and also when combined with chlorthalidone. Plasma renin activity and plasma atenolol concentration were also measured.
2. After the administration of atenolol alone, there was a decrease in mean blood pressure from 131·8 ± sem 2·88 mmHg to 119·0 ± 4·05 mmHg (P < 0·001), in heart rate from 76·4 ± 3·58 beats/min to 57·0 ± 2·55 beats/min (P < 0·001), in calf blood flow from 9·23 ± 1·39 ml min−1100 g−1 to 5·05 ± 0·89 ml min−1 100 g−1 (P < 0·001), and an increase in calf vascular resistance from 16·54 ± 1·90 (mmHg min−1100 g−1)/ml to 28·53 ± 3·40 (mmHg min−1 100 g−1)/ml) (P < 0·005). Atenolol did not alter the pre-ejection period index significantly (P > 0·1). In atenolol-treated patients, upon addition of chlorthalidone there was a further decrease in mean blood pressure from 119·0 ± 4·05 mmHg to 105·9 ± 4·12 mmHg (P < 0·001). There was no further significant alteration in heart rate, pre-ejection period index, calf blood flow or calf vascular resistance.
3. Atenolol decreased plasma renin activity from 4·69 ± 0·87 to 2·85 ± 0·68 ng h−1 ml−1 (P < 0·05), and the addition of chlorthalidone increased it from 2·85 ± 0·68 to 3·81 ± 0·98 ng h−1 ml−1 (P < 0·05).
4. There was a 7·8 fold-interindividual variability in the relationship between plasma atenolol concentration and the dose of atenolol after a single oral dose of 100 mg of the drug.
