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β-receptor blockers significantly impact the cardiovascular system by counteracting catecholamine-induced sympathetic responses. These medications decrease heart rate, contractility, and cardiac output, potentially leading to cardiac depression, life-threatening bradycardia, and death. Therapeutically, β-blockers function as mild antihypertensives and are utilized in treating angina pectoris and cardiac arrhythmias. However, nonselective β-blockers inhibit β2-receptors in...
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β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
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β-adrenergic antagonists, or β-blockers, modulate the sympathetic nervous system by targeting β-adrenoceptors and inhibiting catecholamine-mediated sympathetic responses. β-blockers differ in their adrenoceptor subtype affinity, lipophilicity, and α-blocking capabilities. The history of β-blocker development began with the prototype, dichloroisoprenaline, which exhibited partial agonist activity. As a result, propranolol was developed as a pure antagonist but...
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Beta-blockers for hypertension.

Charles S Wiysonge1,2, Hazel A Bradley3, Jimmy Volmink1,2

  • 1Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Cape Town, Western Cape, South Africa, 7505.

The Cochrane Database of Systematic Reviews
|January 21, 2017
PubMed
Summary
This summary is machine-generated.

Beta-blockers show modest cardiovascular disease reductions but little effect on mortality when used as first-line hypertension therapy. Their effectiveness is inferior to other antihypertensive drugs, with higher risks of adverse events compared to RAS inhibitors.

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Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • Beta-blockers are a diverse drug class with established benefits in heart failure and myocardial infarction.
  • Their efficacy as first-line therapy for hypertension without specific indications remains controversial.
  • This review updates previous Cochrane analyses from 2007 and 2012.

Purpose of the Study:

  • To evaluate the impact of beta-blockers on morbidity and mortality in adults with hypertension.
  • To compare beta-blockers against placebo and other antihypertensive drug classes.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) of at least one year duration.
  • Searched multiple databases including Cochrane Hypertension, CENTRAL, MEDLINE, Embase, and ClinicalTrials.gov up to June 2016.
  • Data extracted in duplicate, with results analyzed using risk ratios (RR) and confidence intervals (CI), and certainty of evidence assessed using GRADE.

Main Results:

  • Thirteen RCTs (40,245 participants) compared beta-blockers (mostly atenolol) to placebo, diuretics, CCBs, or RAS inhibitors.
  • No significant difference in all-cause mortality versus placebo, diuretics, or RAS inhibitors; higher mortality versus CCBs.
  • Modest reduction in total CVD and stroke compared to placebo, but worse CVD outcomes and increased stroke compared to CCBs and RAS inhibitors.

Conclusions:

  • Most included RCTs had a high risk of bias; newer beta-blockers were not evaluated.
  • Initiating hypertension treatment with beta-blockers yields modest CVD benefits and minimal mortality impact.
  • Beta-blocker efficacy is inferior to other antihypertensives, with higher discontinuation rates due to adverse events compared to RAS inhibitors.