Cognitive function in hypertensives treated with atenolol or propranolol

Study objective:To test reports that beta blockers, particularly lipopbilic forms, impair cognitive function and cause psychiatric disturbances. Design:Randomized, double-blind, controlled crossover trial with eight-week treatment periods. Patients:Sequential sample of 43 male veterans, with untreated diastolic blood pressures (DBP) between 90 and 110 mmHg, aged 35-64 years. Interventions:Propranolol-LA, 80-mg tablets, or atenolol, 50-mg tablets, were given daily, incremented by one tablet at weekly intervals until DBP ≤90 mmHg. Hydrochlorothiazide was added, if necessary. Main results:Repeated-measures ANOVA was performed on all cognitive tests. Cognitive test performance was not affected by beta blocker therapy in seven of nine tests and was enhanced on Trail Making Test. Performance was impaired only on Digit Cancellation. Neither Speilberger's State Trait Anxiety Inventory nor the Beck Depression Inventory was affected by either beta blocker. Conclusions:Atenolol or propranolol therapy does not impair cognitive function or contribute significantly to psychiatric side effects.