Beta-blockers for hypertension

UPDATED

Charles S Wiysonge1,2, Hazel A Bradley3, Jimmy Volmink1,2, Bongani M Mayosi4, Lionel H Opie5

1. South African Medical Research Council, Cochrane South Africa, Cape Town, Western Cape, South Africa
2. Stellenbosch University, Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Cape Town, South Africa
3. University of the Western Cape, School of Public Health, Cape Town, South Africa
4. J Floor, Old Groote Schuur Hospital, Department of Medicine, Cape Town, South Africa
5. Medical School, Hatter Cardiovascular Research Institute, Cape Town, South Africa

Wiysonge CS, Bradley HA, Volmink J, Mayosi BM, Opie LH. Beta-blockers for hypertension. Cochrane Database of Systematic Reviews 2017, Issue 1. Art. No.: CD002003. DOI: 10.1002/14651858.CD002003.pub5

Access the full-text article here: 10.1002/14651858.CD002003.pub5

What is the aim of this review?

The aim of this Cochrane Review was to assess whether beta-blockers decrease the number of deaths, strokes, and heart attacks associated with high blood pressure in adults. We collected and analysed all relevant studies to answer this question and found 13 relevant studies.

Are beta-blockers as good as other medicines when used for treatment of adults with high blood pressure?

Beta-blockers were not as good at preventing the number of deaths, strokes, and heart attacks as other classes of medicines such as diuretics, calcium-channel blockers, and renin-angiotensin system inhibitors. Most of these findings come from one type of beta-blocker called atenolol. However, beta-blockers are a diverse group of medicines with different properties, and we need more well-conducted research in this area.

What was studied in the review?

Millions of people with high blood pressure have strokes, heart attacks, and other diseases, and many of them die. This situation could be prevented with appropriate treatment. Researchers have tried different medicines for treating high blood pressure.

What are the main results of the review?

We found 13 studies from high-income countries, mainly Western Europe and North America. In the studies, the people receiving beta-blockers were compared to people who received no treatment or other medicines. The studies showed the following.

Beta-blockers probably make little or no difference in the number of deaths among people on treatment for high blood pressure. This effect appears to be similar to that of diuretics and renin-angiotensin system inhibitors, but beta-blockers are probably not as good at preventing deaths from high blood pressure as calcium-channel blockers.

Beta-blockers may reduce the number of strokes, an effect which appears to be similar to that of diuretics. However, beta-blockers may not be as good at preventing strokes as renin-angiotensin system inhibitors or calcium-channel blockers.

Beta-blockers may make little or no difference to the number of heart attacks among people with high blood pressure. The evidence suggests that this effect may not be different from that of diuretics, renin-angiotensin system inhibitors, or calcium-channel blockers. However, among people aged 65 years and older, the evidence suggests that beta-blockers may not be as good at reducing heart attacks as diuretics.

People given beta-blockers are more likely to have side effects and stop treatment than people taking renin-angiotensin system inhibitors, but there may be little or no difference in side effects between beta-blockers and diuretics or calcium-channel blockers.

How up-to-date is this review?

The review authors searched for studies that had been published up to June 2016.