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Senior Citizen Health & Medicine
Beta-Blockers Should Not Be First Choice for High
Blood Pressure
Slightly higher risk of death, cardiovascular
disease than using calcium channel blockers
By Becky Ham, Science Writer, Health Behavior News
Service
Feb. 21, 2007 - Beta-blocker drugs such as Tenormin, Inderal and
Lopressor should not be a doctors first choice for treating high blood
pressure, according to a large new review of studies.
The review, coming on the heels of several similar
large reviews, found that beta-blocker users have a slightly higher risk
of death and cardiovascular disease than patients who use calcium
channel blockers such as Norvasc and Cardizem to manage their blood
pressure.
Patients who take diuretics such as
hydrochlorothiazide or a group of drugs called RAS inhibitors (brand
names include Altace, Lotensin, and Cozaar) have risks similar to those
taking beta-blockers.
Dr. Charles Shey Wiysonge of the Ministry of Public
Health in Cameroon, who led the new review, said many recent reviews
arrived at similar conclusions that the available evidence does not
support the use of beta-blockers as first-line drugs in the treatment of
hypertension.
The review appears in the latest issue of The
Cochrane Library, a publication of The Cochrane Collaboration, an
international organization that evaluates medical research. Systematic
reviews draw evidence-based conclusions about medical practice after
considering both the content and quality of existing medical trials on a
topic.
Wiysonge said the Cochrane review is different from
other recent reviews because it compares beta-blockers head-to-head
against specific antihypertensive medications, rather than comparing
beta-blockers against all other high blood pressure medicines as a
group.
After combing through 13 studies of 91,561
patients, Wiysonge and colleagues found no difference in the risk of
death or cardiovascular disease among those who used beta-blockers,
diuretics and RAS inhibitor drugs.
However, the absolute risk of death was a
half-percent greater among beta-blocker users compared to those taking
calcium channel blockers.
In addition, patients taking beta-blockers had a
1.3 percent increase in the risk of cardiovascular disease mostly
strokes compared to those taking calcium channel blockers.
Also, patients who used beta-blockers were more
likely to experience undesirable effects and abandon their
antihypertension medications compared to patients who took diuretics or
RAS inhibitors, Wiysonge said.
A review of 22 studies published in the medical
journal The Lancet in January may suggest another reason to be wary of
beta-blockers for high blood pressure. The review concluded that
diuretics and beta-blocker treatments may increase the chances of
developing type 2 diabetes.
Lancet author Dr. William Elliott of Rush
University Medical Center in Chicago said antihypertensive drugs such as
ACE inhibitors and angiotensin receptor blockers types of RAS drugs
were associated with the lowest risk of developing diabetes.
The review was supported by the Medical Research
Council, University of Cape Town, University of the Western Cape and
University of Stellenbosch, South Africa, and the Ministry of Public
Health, Cameroon.
Editor's Notes:
Source: Wiysonge CS, et al. Beta-blockers for
hypertension (Review). Cochrane Database of Systematic Reviews 2007,
Issue 1.
The Cochrane Collaboration is an international
nonprofit, independent organization that produces and disseminates
systematic reviews of health care interventions and promotes the search
for evidence in the form of clinical trials and other studies of
interventions. Visit http://www.cochrane.org for more information.
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