Turk Kardiyol Dern Ars. 2005; 33(4): 241-247

Beta-blockers for the treatment of hypertension: does the Emperor really have no clothes on?

Adnan Abacı¹

The benefit of lowering blood pressure in hypertension has been clearly demonstrated. However, apart from their role in lowering blood pressure, there is debate as to whether some antihypertensive drugs confer protection from cardiovascular events. Recently, the effectiveness of beta-blockers has been questioned in the treatment of hypertension. Many controlled randomized trials have compared the older (diuretics and beta-blockers) and newer (calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers) antihypertensive agents. Meta-analyses of these trials have shown that both the older and newer agents are associated with similar reductions in cardiovascular end points. Even though beta-blockers, along with diuretics, have recently been shown to be associated with new diabetic cases, they are still effective in reducing cardiac events in diabetic patients. In the comparison of antihypertensive agents, findings of all recent major studies but one do not negate the effectiveness of beta-blockers. On the basis of available data, one class of antihypertensive drug cannot be favored over others on the grounds that it offers specific benefits apart from its inherent use. Therefore, it is still convenient to consider beta-blockers for the initiation and maintenance of antihypertensive therapy in the majority of hypertensive patients.

Keywords: Adrenergic beta-antagonists/therapeutic use/ adverse effects; antihypertensive agents/therapeutic use; cardiovascular diseases/prevention & control; diuretics/ therapeutic use; hypertension/drug therapy

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