Beta-blockers for hypertension: time to call a halt

Beta-blockers are not very effective at lowering blood pressure in elderly hypertensive patients or in Afro-Caribbeans and these two groups represent a large proportion of people with raised blood pressure. Furthermore they do not prevent more heart attacks than the thiazide diuretics. Beta-blockers can also be dangerous in many hypertensive patients and even when these drugs are not contraindicated, they cause subtle and depressing side effects which should preclude their usefulness. The time has come therefore to reconsider the endorsement of beta-blockers by the British Hypertension Society and other guidelines committees, except possibly for severe resistant hypertension, high risk post-infarct patients and those with angina pectoris. The time has come to move across to newer, safer, more tolerable and more effective antihypertensive agents whilst continuing to use thiazide diuretics in low doses in the elderly as first choice, providing there are no contraindications.