A meta-analysis of mortality and coronary prevention in hypertensive patients treated with beta-receptor blockers

As beta-adrenoreceptor blockers have been shown to reduce mortality following myocardial infarction by around 20%, a similar pattern of 'cardioprotection' was looked for in hypertensive patients. Several non-randomised retrospective studies have suggested that beta-blockers may reduce either the mortality or morbidity from vascular complications. In the three randomised studies published to date, the effect of beta-blockers was compared with other managements using the technique of meta-analysis or overview. The overall mortality rate ratio in hypertensive patients treated with beta-blockers compared with those receiving placebo or diuretic treatment was 0.93 (95% confidence interval, 0.8 to 1.1). The pooled rate ratio for coronary heart disease (CHD) events was 0.95 and for cerebrovascular accidents 0.92. When beta-blockers were compared with diuretics, the overall pooled mortality rate ratio was 0.93 (95% confidence interval, 0.8 to 1.1). The pooled rate ratios for CHD events and cerebrovascular disease events were 0.98 and 1.22, respectively. These results raise the possibility that, in hypertensive patients, treatment with beta-blockers is associated with a small reduction in overall mortality when compared with other treatments.