In which patient demographic should atenolol be avoided?

Atenolol is a beta-blocker commonly used to manage conditions like hypertension and certain types of heart disease. However, it can cause bronchoconstriction due to its action on beta-2 adrenergic receptors located in the bronchial smooth muscle. For this reason, it is often advised to avoid using atenolol in patients with asthma or other reactive airway diseases.

In the scenario provided, the patient demographic that should avoid atenolol is the 43-year-old female with asthma. In asthmatic individuals, beta-blockers can exacerbate bronchospasm and lead to respiratory complications. Therefore, alternative medications that do not possess significant beta-2 antagonistic effects would be preferred for managing her hypertension or any associated conditions.

The other patients mentioned do not present the same contraindication. For instance, a 30-year-old male smoker may be at risk for cardiovascular issues but does not have a specific contraindication associated with atenolol use. Similarly, the 55-year-old male with hypertension could likely benefit from atenolol, considering his condition, while the 25-year-old female without pre-existing conditions poses no concerns regarding atenolol use. Thus, the avoidance of atenolol in patients with asthma is the primary reason