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Review: ß blockers differ in their efficacy for preventing major cardiovascular events in younger and older patients

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

Key Words: adrenergic ß antagonists • hypertension

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

METHODS
Data sources PubMed (1950 to January 2006), reference lists of hypertension meta-analyses, and experts.

Study selection and assessment randomised controlled trials (RCTs) with blinded assessment of outcome that compared ß blockers with placebo or other antihypertensive drugs as first line therapy for hypertension. 21 RCTs met the selection criteria: 10 trials (n = 50 612) involved younger patients (mean age 46–56 y), and 11 trials (n = 95 199) involved older patients (mean age 60–76 y).

Outcomes a composite end point of stroke, myocardial infarction (MI), or death; stroke; MI; death; and heart failure.

MAIN RESULTS
In younger patients, ß blockers reduced risk of the composite end point more than placebo and did not differ from other antihypertensive drugs (table). In older patients, ß blockers did not differ from placebo for the composite end point and increased risk more than other antihypertensive drugs (table). In younger patients, ß blockers did . . . [Full text of this article]

Robert Weiss, MD

Androscoggin Cardiology Associates,
Auburn, Maine, USA