Are Beta-Blockers Efficacious as First-Line Therapy for Hypertension in the Elderly?

Journal of Clinical and Basic Cardiology 2001; 4 (3): 235-238

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Keywords: Betablocker,  Hypertonie,  Kardiologie,  Studie,  beta-blocker,  cardiology,  controlled studies,  hypertension

To assess antihypertensive efficacy of beta-blockers and their effects on cardiovascular morbidity and mortality and all cause mortality in elderly patients with hypertension randomised placebo-controlled studies, trials with untreated controls and with comparison of antihypertensive drugs were selected from the literature, in which beta-blockers were used in hypertension of elderly patients. The relative risk reduction of primary endpoints, the significance and 95 % confidence interval were calculated. There were six trials in which elderly patients were treated with beta-blockers for hypertension (three trials placebo-controlled, one study with untreated control, and two studies with comparison of antihypertensive drugs). There was no study with monotherapy of beta-blockers. In combination with diuretics beta-blockers were superior to placebo and untreated controls in preventing cardiovascular events, especially strokes, but there was no superiority of beta-blockers to ACE-inhibitors and Ca-antagonists in preventing cardiovascular morbidity and mortality and total mortality in elderly patients with hypertension. Beta-blockers are only in combination with diuretics efficacious in preventing cardiovascular morbidity and mortality in elderly patients with hypertension.