In which condition is atenolol contraindicated?

Atenolol is a beta-blocker that is primarily used to manage hypertension, angina, and other cardiovascular conditions. However, it is contraindicated in individuals with asthma or reactive airway disease. The reason for this contraindication is that atenolol can lead to bronchoconstriction because it blocks beta-2 adrenergic receptors in the lungs, which are responsible for bronchodilation. In patients with asthma, this effect could exacerbate their condition by narrowing the airways, potentially leading to difficulty in breathing or an asthma attack.

In contrast, atenolol may be used cautiously in the context of diabetes and hypertension. While there are considerations for using atenolol in patients with diabetes—such as the potential for masking hypoglycemia symptoms—it is not outright contraindicated. Similarly, it is primarily indicated for hypertension management. Osteoporosis is not a direct contraindication, as there are no major concerns about atenolol worsening this condition. Thus, the most critical and relevant contraindication for atenolol is its use in patients with asthma.