Key result
Beta-blockers increased the risk of major cardiovascular events compared to other antihypertensive agents in older patients (RR 1.06), but reduced events compared to placebo in younger patients (RR 0.86).
Why the study?
Do beta-blockers as first-line therapy reduce major cardiovascular outcomes in younger versus older patients with hypertension?
Population
145,811 participants in 21 randomized controlled trials of hypertension, stratified by mean age at baseline…
Comparison
Beta-blockers as first-line therapy for… vs Placebo or active comparator
Design
Meta-analysis
Authors
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Supports first-line beta-blockers in younger hypertensives but not older; challenges uniform guideline recommendations across ages.
Meta-Analysis (n=145,811)
Do beta-blockers as first-line therapy reduce major cardiovascular outcomes in younger versus older patients with hypertension?
Effect estimate: RR 1.06 (95% CI 1.01-1.10)
Beta-blockers are effective as first-line therapy for hypertension in younger patients but should not be considered first-line in older patients due to lack of benefit and increased risk of stroke compared to other agents.
Nadia Khan (2006) conducted a meta-analysis in Hypertension (n=145,811). Beta-blockers vs. Placebo or other antihypertensive agents was evaluated on Composite of stroke, myocardial infarction and death (older patients ≥60 years vs active comparator) (RR 1.06, 95% CI 1.01-1.10). Beta-blockers increased the risk of major cardiovascular events compared to other antihypertensive agents in older patients (RR 1.06), but reduced events compared to placebo in younger patients (RR 0.86).
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