Of the 8, 037 people regarding presumed severe myocardial infarction randomized to Tenormin in the ISIS-1 test (See CLINICAL PHARMACOLOGY), 33 % (2, 644) were 65 years of age and also older. It was not possible to recognize substantial differences in efficiency as well as safety between older and also more youthful individuals; nonetheless, elderly clients with systolic blood stress < 120 mmHg seemed less likely to benefit (See INDICATIONS AND USAGE).
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In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Evaluation of patients with hypertension or myocardial infarction should always include assessment of renal function.
The frequency estimates in the following table were derived from controlled studies in hypertensive patients in which adverse reactions were either volunteered by the patient (US studies) or elicited, eg, by checklist (foreign studies). The reported frequency of elicited adverse effects was higher for both Tenormin and placebo-treated patients than when these reactions were volunteered. Where frequency of adverse effects of Tenormin and placebo is similar, causal relationship to Tenormin is uncertain.
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In a series of investigations in the treatment of acute myocardial infarction, bradycardia and hypotension occurred more commonly, as expected for any beta blocker, in atenolol-treated patients than in control patients. However, these usually responded to atropine and/or to withholding further dosage of atenolol. The incidence of heart failure was not increased by atenolol. Inotropic agents were infrequently used. The reported frequency of these and other events occurring during these investigations is given in the following table.