Q: I am a 50-year-old male. I have been advised to take Stamlo Beta (one tablet daily) for hypertension. I appeared for a computerised stress test for an LIC policy. I was told to take Losar for three days instead of Stamlo Beta. When enquired, I was told that Stamlo Beta does not allow your heart rate to increase beyond a certain limit. So I should stop taking it and take Losar, and then appear for the test again. After three days the test was performed. Can you kindly explain why is it so? Does it mean that one should avoid substantial exercise if he is on Stamlo Beta?

A:Stamlo Beta is the brand name of a combination product that contains amlodipine and atenolol. Atenolol decreases pulse rate. Recent research indicates that atenolol can precipitate diabetes and is less effective than other agents, apart from causing erectile dysfunction in sexually active males. Hence, it should not be used unless other medicines are ineffective. As per globally accepted guidelines, in patients younger than 55, first choice initial therapy should be Enalapril (sold under various brand names such as Enam) 5-10 mg 1-2 times daily as needed. In cases where Enalapril is not tolerated (in some patients it causes persistent dry cough), Losartan (sold as Lozitan) 50-100 mg once daily can be used. If two drugs are required, then add amlodipine 5 mg or a diuretic such as metolazone (sold as Metoz) 2.5 mg in the morning.