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Britain's National Health Service spends 23 million pounds a year on 'placebo'

A drug prescribed to more than two million Britons with high blood pressure is no better than placebo pills in preventing deaths from strokes and heart disease, research has shown. Atenolol is the most common of the beta-blocker drugs used to lower blood pressure and reduce the risk of heart attacks and stroke. It costs the NHS 23 million pounds a year.

But analysis of the data by scientists in Sweden indicates that - although it reduces blood pressure - it is no better than placebo pills in preventing deaths. Other beta-blockers do a much better job, the team writing in The Lancet say. The researchers, from Umea and Salgrenska University Hospitals, said: "Our results cast doubts on atenolol as a suitable drug for hypertensive patients."

Atenolol has been out of patent since 1991. That means that there are many cheap versions of the drug, originally marketed by AstraZeneca as Tenormin. Data from Compufile, a company that monitors prescribing, shows that atenolol accounts for three quarters of all prescriptions for beta-blockers. In the year to the end of September, almost 16 million atenolol prescriptions were issued, to 2.15 million patients. The next most popular beta-blocker, bisoprolol, sold only a tenth as many.

The Swedish team, led by Professor Lars Lindholm, carried out a review of the literature on atenolol. They found five studies that compared atenolol with placebo pills, and five that compared it with other blood pressure drugs. The comparisons with placebo show that atenolol does reduce blood pressure. This should reduce the risk of strokes and heart disease. The team found that stroke risk was reduced, by 15 per cent, but that this benefit did not feed through into reductions of deaths. In the four studies, covering 6,825 patients and with a follow-up period of more than 4« years, there were no reductions in deaths from all causes, or in heart attacks.

When atenolol is compared with other treatments for high blood pressure, it comes out poorly, the team concludes. The trials they examined covered 17,671 patients followed up for 4« years, on average. Risks of death from [?] were 13 per cent higher for atenolol than for other treatments, deaths from heart attack or stroke were 16 per cent higher, and strokes 30 per cent higher.

The researchers suggest that atenolol does not permeate readily into the central nervous system, making it possibly less effective in controlling dangerous rhythm variations of the heart. Other blood pressure drugs correct the malfunctioning of artery walls seen in people with high blood pressure, but atenolol does not.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

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