Use of Beta-Blockers as a First-Line Treatment for Primary Hypertension

<i>Background</i>: Even though beta-blockers had been used as a first-line therapy for hypertension, since the late 1960s, the Eighth Joint National Committee, JNC 8, decided to recommend them no longer. This decision was based on relatively weak evidence from previous studies, which fou...

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Main Authors: Maryam Izadi, Shiva Shafabakhsh, Amir Mirnateghi
Format: Article
Language:English
Published: MDPI AG 2024-10-01
Series:Hearts
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Online Access:https://www.mdpi.com/2673-3846/5/4/33
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author Maryam Izadi
Shiva Shafabakhsh
Amir Mirnateghi
author_facet Maryam Izadi
Shiva Shafabakhsh
Amir Mirnateghi
author_sort Maryam Izadi
collection DOAJ
description <i>Background</i>: Even though beta-blockers had been used as a first-line therapy for hypertension, since the late 1960s, the Eighth Joint National Committee, JNC 8, decided to recommend them no longer. This decision was based on relatively weak evidence from previous studies, which found that first-line beta-blockers were less effective in reducing stroke and heart failure, the main outcomes of hypertension. Despite the general perception, the most common events caused by hypertension are death and MI, not stroke or heart failure. Therefore, this study aimed to clarify beta-blocker efficacy by incorporating the data from all relevant beta-blocker trials, using the composite outcome of major cardiovascular events. <i>Method</i>: A search was conducted on MEDLINE, PubMed, Embase, and the Cochrane Library, restricted to published, peer-reviewed, human, meta-analysis, and controlled clinical trials. The term words used were “beta-blockers or adrenergic beta antagonists”, “hypertension”, and “death or coronary heart disease or stroke or congestive heart failure or myocardial infarction”. For this research, we selected six randomized controlled trials, and three meta-analyses were also chosen. <i>Results</i>: The results showed that beta-blockers were as effective as other first-line medications in younger hypertensive patients. On the other hand, in the patients aged above 60, the results were mixed. Beta-blockers were more effective than diuretics, but inferior to angiotensin receptor blockers. Also, beta-blockers were as safe and effective as angiotensin-converting enzyme inhibitors in reducing coronary heart disease, myocardial infarction, heart failure, and sudden death. However, beta-blockers were inferior to calcium channel blockers in reducing strokes. <i>Conclusions</i>: Beta-blockers were found to be the most effective in many aspects except for strokes. Further studies are needed to assess beta-blockers’ effectiveness in treating primary hypertension.
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spelling doaj-art-c5b167ca2d564daeafbb6fa9bdfa85ce2025-08-20T02:50:59ZengMDPI AGHearts2673-38462024-10-015446047110.3390/hearts5040033Use of Beta-Blockers as a First-Line Treatment for Primary HypertensionMaryam Izadi0Shiva Shafabakhsh1Amir Mirnateghi2Chiropractic Department, Keiser University, West Palm Beach, FL 33411, USAWalgreens, West Palm Beach, FL 33441, USACollege of Osteopathic Medicine, LECOM University, Bradenton, FL 34211, USA<i>Background</i>: Even though beta-blockers had been used as a first-line therapy for hypertension, since the late 1960s, the Eighth Joint National Committee, JNC 8, decided to recommend them no longer. This decision was based on relatively weak evidence from previous studies, which found that first-line beta-blockers were less effective in reducing stroke and heart failure, the main outcomes of hypertension. Despite the general perception, the most common events caused by hypertension are death and MI, not stroke or heart failure. Therefore, this study aimed to clarify beta-blocker efficacy by incorporating the data from all relevant beta-blocker trials, using the composite outcome of major cardiovascular events. <i>Method</i>: A search was conducted on MEDLINE, PubMed, Embase, and the Cochrane Library, restricted to published, peer-reviewed, human, meta-analysis, and controlled clinical trials. The term words used were “beta-blockers or adrenergic beta antagonists”, “hypertension”, and “death or coronary heart disease or stroke or congestive heart failure or myocardial infarction”. For this research, we selected six randomized controlled trials, and three meta-analyses were also chosen. <i>Results</i>: The results showed that beta-blockers were as effective as other first-line medications in younger hypertensive patients. On the other hand, in the patients aged above 60, the results were mixed. Beta-blockers were more effective than diuretics, but inferior to angiotensin receptor blockers. Also, beta-blockers were as safe and effective as angiotensin-converting enzyme inhibitors in reducing coronary heart disease, myocardial infarction, heart failure, and sudden death. However, beta-blockers were inferior to calcium channel blockers in reducing strokes. <i>Conclusions</i>: Beta-blockers were found to be the most effective in many aspects except for strokes. Further studies are needed to assess beta-blockers’ effectiveness in treating primary hypertension.https://www.mdpi.com/2673-3846/5/4/33beta-blockersadrenergic beta antagonistsprimary hypertension
spellingShingle Maryam Izadi
Shiva Shafabakhsh
Amir Mirnateghi
Use of Beta-Blockers as a First-Line Treatment for Primary Hypertension
Hearts
beta-blockers
adrenergic beta antagonists
primary hypertension
title Use of Beta-Blockers as a First-Line Treatment for Primary Hypertension
title_full Use of Beta-Blockers as a First-Line Treatment for Primary Hypertension
title_fullStr Use of Beta-Blockers as a First-Line Treatment for Primary Hypertension
title_full_unstemmed Use of Beta-Blockers as a First-Line Treatment for Primary Hypertension
title_short Use of Beta-Blockers as a First-Line Treatment for Primary Hypertension
title_sort use of beta blockers as a first line treatment for primary hypertension
topic beta-blockers
adrenergic beta antagonists
primary hypertension
url https://www.mdpi.com/2673-3846/5/4/33
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AT amirmirnateghi useofbetablockersasafirstlinetreatmentforprimaryhypertension