The article that I linked in comment# 5 of this thread was the last that Lindholm had printed in Lancet according to an author search on PubMed.
It failed to find the latest Lancet article found by searching directly at Lancet. Here is its abstract:
The Lancet Early Online Publication, 18 October 2005
DOI:10.1016/S0140-6736(05)67573-3
Should β 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
Beta-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 (CI 7 Â 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, Umea University Hospital, Umea, Sweden b Department of Nephrology, Sahlgrenska University Hospital, Goteborg, Sweden
Correspondence to: Prof Lars H Lindholm, Department of Public Health and Clinical Medicine, Umea University Hospital, SE 901 85 Umea, Sweden
Here's the URL:
http://www.thelancet.com/journals/lancet/article/PIIS0140673605675733/abstract?iseop=true
You'll have to register, not subscribe, before you can access the abstract.
Check with your doc before you make any changes. The article doesn't differentiate between the two main types of stroke.
Thanks - I've been on atenolol for 13 years.......yikes!
Thanks for the information (and the ping).