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

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 Q When used as first line treatment of hypertension, does the efficacy of β blockers for preventing major cardiovascular events differ between younger and older patients?

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


Embedded ImageData sources

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

Embedded ImageStudy selection and assessment

randomised controlled trials (RCTs) with blinded assessment of outcome that compared β 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).

Embedded ImageOutcomes

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


In younger patients, β blockers …

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  • For correspondence: Dr F McAlister, University of Alberta Hospital, Edmonton, Alberta, Canada. finlay.mcalister{at}

  • Source of funding: no external funding.