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Review: ß blockers are less effective than other antihypertensive drugs for reducing risk of stroke in primary hypertension

Clinical impact ratings GP/FP/Primary care IM/Ambulatory care Cardiology

Key Words: adrenergic beta antagonists • atenolol • hypertension

The first 150 words of the full text of this article appear below.

METHODS
Data sources: PubMed and the Cochrane Library.

Study selection and assessment: randomised controlled trials (RCTs) that compared ß blockers as first line treatment with placebo, no treatment, or other antihypertensive drugs in patients with primary hypertension. Subgroup analyses were conducted for non-atenolol ß blockers, mixed ß blockers or diuretics, and atenolol. 13 RCTs (n = 133 384) met the selection criteria.

Outcomes: all cause mortality, stroke, and MI.

MAIN RESULTS
ß blockers led to a lower incidence of stroke than did placebo or no treatment, but resulted in a higher incidence of stroke than did other antihypertensive drugs (table). Atenolol led to a higher incidence of stroke (relative risk [RR] 1.26, 95% CI 1.15 to 1.38) and all cause mortality (RR 1.08, CI 1.02 to 1.14) than did other antihypertensive drugs, but did not increase MI. Patients who received non-atenolol ß blockers or mixed ß blockers or diuretics did not differ from . . . [Full text of this article]

Peter Rudd, MD

Stanford University School of Medicine, Stanford, California, USA