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Beta-adrenergic antagonists in hypertension: a review of the evidence

T Scott Warmack1, Mark A Estes, Seth Heldenbrand

  • 1Department of Pharmacy Practice, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

The Annals of Pharmacotherapy
|November 26, 2009
PubMed

Insights

Beta-blocker therapy for hypertension shows reduced risks for stroke and heart failure in placebo trials. However, compared to other antihypertensives, beta-blockers may increase stroke risk, with insufficient data to support their preferred use.

Area of Science:

  • Cardiology
  • Pharmacology
  • Hypertension Research

Background:

  • Hypertension management is crucial for preventing cardiovascular and cerebrovascular events.
  • Beta-adrenergic antagonists (beta-blockers) are widely used antihypertensive agents.
  • Evaluating the comparative effectiveness of beta-blockers is essential for optimal patient care.

Purpose of the Study:

  • To assess the impact of beta-blocker therapy on cardiovascular and cerebrovascular outcomes in patients with hypertension.
  • To compare the efficacy and safety of beta-blockers against placebo and other antihypertensive medications.

Main Methods:

  • Systematic literature searches of MEDLINE, International Pharmaceutical Abstracts, and Cochrane Database.
  • Inclusion of English-language clinical trials and meta-analyses focusing on hypertension and relevant outcomes.
  • Exclusion of studies not directly addressing hypertension or cardiovascular/cerebrovascular endpoints.

Main Results:

  • Placebo-controlled trials indicate beta-blockers reduce risks of stroke, cardiovascular events, and heart failure.
  • Active-controlled studies show limited significant benefit of beta-blockers over other agents.
  • Meta-analyses suggest an increased risk of stroke, and potentially cardiovascular events and mortality, with beta-blockers, particularly atenolol.

Conclusions:

  • Current evidence is insufficient to establish beta-blockers as a preferred first-line therapy for hypertension.
  • While atenolol is associated with adverse outcomes, data on other beta-blockers in hypertension remain limited.
  • Further research is needed to clarify the role of different beta-blockers in hypertension management.
Abstract

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