"Beta blockers won't harm you," he said.
Unless you have a history of bronchospastic disease, e.g. asthma, chronic obstructive pulmonary disease, use a beta2 agonist, etc., then check the precautions and beware of possible adverse reactions.
The Lancet 2005; 366:1545-1553
DOI:10.1016/S0140-6736(05)67573-3
Should β(beta) blockers remain first choice in the treatment of primary hypertension? A meta-analysis Lars Hjalmar Lindholm a , Bo Carlberg a and Ola Samuelsson b
Summary Background β blockers have been used widely in the treatment of hypertension and are recommended as first-line drugs in hypertension guidelines. However, a preliminary analysis has shown that atenolol is not very effective in hypertension. We aim to substantially enlarge the data on atenolol and analyse the effect of different β blockers.
Methods The Cochrane Library and PubMed were searched for β blocker treatment in patients with primary hypertension. Data were then entered into the Cochrane Collaboration Review Manager package and were summarised in meta-analyses. 13 randomised controlled trials (n=105 951) were included in a meta-analysis comparing treatment with β blockers with other antihypertensive drugs. Seven studies (n=27 433) were included in a comparison of β blockers and placebo or no treatment.
Findings The relative risk of stroke was 16% higher for β blockers (95% CI 4–30%) than for other drugs. There was no difference for myocardial infarction. When the effect of β blockers was compared with that of placebo or no treatment, the relative risk of stroke was reduced by 19% for all β blockers (7–29%), about half that expected from previous hypertension trials. There was no difference for myocardial infarction or mortality.
Interpretation In comparison with other antihypertensive drugs, the effect of β blockers is less than optimum, with a raised risk of stroke. Hence, we believe that β blockers should not remain first choice in the treatment of primary hypertension and should not be used as reference drugs in future randomised controlled trials of hypertension.
Affiliations
a Department of Public Health and Clinical Medicine, Umeå University Hospital, Umeå, Sweden b Department of Nephrology, Sahlgrenska University Hospital, Göteborg, Sweden
Correspondence to: Prof Lars H Lindholm, Department of Public Health and Clinical Medicine, Umeå University Hospital, SE 901 85 Umeå, Sweden
Beta blockers won't harm you, huh? Tell that to those who have had heart attacks, strokes, etc. from the use of these. I refuse to use it for my arrhythmias, bad as they are, b/c I have a high risk for these anyway!