Researchers yesterday questioned the effectiveness of a widely prescribed drug for reducing blood pressure.

A review of nine studies suggested that atenolol, a beta-blocker which slows heart activity, was no better than dummy pills in reducing death from heart disease or heart attacks although it did reduce stroke.

The authors of the review, published in the Lancet, also had doubts about the drug's use in trials which compared its performance against that of other newer drugs.

"Our results cast doubt on atenolol as a suitable drug for hypertensive patients," said Lars Hjalmar Lindholm, of Umea University in Sweden.

It should not be used as a first-line treatment, Professor Lindholm said.

The Medicines and Healthcare products Regulatory Agency, the British drug safety watchdog, last night said atenolol might be prescribed for other reasons, including to treat angina. "It is important that patients who have been prescribed atenolol do not stop or change their treatment without consulting their doctor."

It would carefully review any new evidence. Belinda Linden, a cardiac nurse with the British Heart Foundation, said that in Britain beta-blockers were the fourth choice of treatment for high blood pressure and worked best in combination with other drugs.

Most patients needed at least two drugs to reach their recommended blood pressure.