Valsartan vs. Atenolol

See how Valsartan and Atenolol compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Valsartan is an ARB that relaxes blood vessels, while atenolol is a beta-blocker that slows the heart to lower blood pressure.

  • Valsartan starts at 80 mg once daily and can go up to 320 mg, while atenolol starts at 50 mg once daily and can go up to 200 mg.

  • Atenolol also treats angina and helps after a heart attack, while valsartan is also approved for heart failure and post-heart-attack survival.

Valsartan vs. Atenolol Drug Summary

Valsartan

Valsartan is an angiotensin II receptor blocker (ARB) that relaxes blood vessels to lower blood pressure. It treats hypertension in adults and children 6 and older, and is also approved for heart failure and to improve survival after a heart attack. It's taken as a tablet once a day, usually starting at 80 mg.

Atenolol

Atenolol is a beta-1 selective blocker that slows the heart rate and reduces the heart's workload to lower blood pressure. It treats hypertension, angina, and is used after a stable heart attack, and is sometimes prescribed off-label for migraine prevention or tremor. It's taken as a tablet once a day, usually starting at 50 mg.

Valsartan vs. Atenolol Side Effects

Valsartan

Most common
dizziness (up to 14%)
fatigue (up to 2%)
headache (up to 14%)
viral infection (up to 3%)

Atenolol

Most common
dizziness (up to 13%)
fatigue (up to 26%)
depression (up to 12%)
cold extremities (up to 12%)

Valsartan vs. Atenolol Dosage

Valsartan

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 80 mg once daily At the start
Maximum dose Up to 320 mg daily If needed
Dose changes 2 increases As tolerated

Atenolol

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 50 mg once daily At the start
Maximum dose 200 mg once daily If needed
Dose changes 2 increases As tolerated

Valsartan vs. Atenolol Indications

Valsartan

Valsartan lowers blood pressure by blocking angiotensin II, a hormone that narrows blood vessels. Beyond hypertension, it's FDA-approved to reduce hospitalization in heart failure and to improve survival after a heart attack. It can be used alone or combined with other blood pressure medications.

  • Hypertension in adults and children 6+

  • Heart failure (NYHA class II-IV)

  • Post-heart attack cardiovascular protection

  • Can be combined with other BP drugs

Atenolol

Atenolol lowers blood pressure and heart rate by blocking beta-1 receptors in the heart. It's FDA-approved for hypertension, chronic angina, and for stable patients after a heart attack. Doctors also prescribe it off-label for migraine prevention and hand tremor.

  • Hypertension in adults

  • Angina pectoris (chest pain)

  • Stable acute myocardial infarction

  • Off-label: migraine prevention, tremor

Valsartan vs. Atenolol Pros and Cons

Valsartan

Valsartan avoids the fatigue and breathing risks tied to beta-blockers, making it a common choice for patients with asthma or diabetes. It's also one of the few blood pressure options with an added heart failure and post-heart-attack indication. It has been available as a generic tablet for many years.

Pros

  • Won't cause the fatigue common with beta-blockers

  • Safe for patients with asthma or COPD

  • Also approved for heart failure and post-heart-attack care

  • Doesn't mask low blood sugar symptoms in diabetes

Cons

  • Must be stopped if pregnancy occurs

  • Can raise potassium, needing monitoring in heart failure

  • Doesn't slow heart rate, so no help for angina

  • Occasional dizziness, especially with first doses

Atenolol

Atenolol slows the heart, which makes it useful for angina and certain rapid-heart-rate situations that valsartan cannot address. It's been used since 1981 and remains one of the least expensive beta-blockers available. It requires more caution around abrupt discontinuation and certain lung conditions.

Pros

  • Also treats angina and stable post-heart-attack care

  • Useful for patients with rapid heart rate or palpitations

  • Long safety track record since 1981

  • One of the least expensive beta-blockers available

Cons

  • Cannot be stopped abruptly without medical guidance

  • Not recommended for patients with asthma or COPD

  • Can mask low blood sugar or thyroid symptoms

  • Common fatigue, cold hands, and low mood

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