Key result
First-line beta-blockers reduced stroke risk vs placebo (RR 0.80; 95% CI 0.66-0.96) but were inferior to CCBs (RR 1.24; 95% CI 1.11-1.40) and RAS inhibitors (RR 1.30; 95% CI 1.11-1.53) for stroke.
Why the study?
Does first-line antihypertensive treatment with beta-blockers reduce mortality and morbidity in patients with hypertension compared to placebo or other antihypertensive agents?
Meta-Analysis (n=91,561)
Does first-line antihypertensive treatment with beta-blockers reduce mortality and morbidity in patients with hypertension compared to placebo or other antihypertensive agents?
Effect estimate: RR 0.80 (95% CI 0.66-0.96)
Beta-blockers are inferior to CCBs and RAS inhibitors for reducing hard clinical endpoints like stroke, and are less well tolerated than diuretics, suggesting they are suboptimal as first-line therapy for hypertension.
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Beta-blockers should not be first-line antihypertensives; confirms inferiority to CCBs and RAS inhibitors for stroke prevention.
Bradley et al. (2006) conducted a meta-analysis in Hypertension (n=91,561). Beta-blockers vs. Placebo, diuretics, calcium-channel blockers, and renin-angiotensin system inhibitors was evaluated on Stroke (vs placebo) (RR 0.80, 95% CI 0.66-0.96). First-line beta-blockers reduced stroke risk vs placebo (RR 0.80; 95% CI 0.66-0.96) but were inferior to CCBs (RR 1.24; 95% CI 1.11-1.40) and RAS inhibitors (RR 1.30; 95% CI 1.11-1.53) for stroke.
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