Choosing a first-line drug in the management of elevated blood pressure: what is the evidence? 2: Beta-blockers.
Elevated blood pressure is associated with an increased risk of cardiovascular illness and death. Efforts to reduce that risk have led to recommendations for a wide array of nondrug and drug therapies. Choosing the optimal first-line drug for hypertensive patients should address a hierarchy of treatment goals: decrease in morbidity and mortality associated with hypertension, decrease in blood pressure, good tolerance, dosing convenience and low cost. This article examines the evidence for beta-blockers as a class of first-line antihypertensive drugs in light of these treatment goals. The evidence indicates that beta-blockers are probably not as effective in reducing morbidity and mortality as low-dose thiazide diuretics and that there may be significant differences in effectiveness among various beta-blockers.
Department of Medicine, University of British Columbia, Vancouver. jmwright@interchange.ubc.ca
J M
JM
Wright
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D001581:Benzothiadiazines; D001794:Blood Pressure / Q000187:drug effects*; D003657:Decision Making; D004232:Diuretics; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D015994:Incidence; D016032:Randomized Controlled Trials as Topic; D049993:Sodium Chloride Symporter Inhibitors / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D015996:Survival Rate; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D001581:Benzothiadiazines; D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors