Which treatment is best for hypertension?


  • Mary Corcoran
  • Univadis Medical News
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Findings from a new analysis suggest that beta-blockers may not be as protective against cardiovascular (CV) events as diuretics, angiotensin II or angiotensin-converting-enzyme (ACE) inhibitors or calcium channel blockers. 

In a new real-world analysis, researchers used data from electronic medical records of 79,288 people adhering to diuretics, beta-blockers, inhibitors of the renin‐angiotensin system (RAS) (angiotensin II inhibitors or ACE inhibitors) and calcium channel blockers. Researchers evaluated relevant patient outcomes over three years from the start of therapy. 

The study found that patients in the group taking RAS blockers for at least three years had the largest reduction in blood pressure and the best blood pressure control. Together with patients taking diuretics, they also had the lowest CV event rates. Patients in the beta-blocker group had the worst blood pressure control and a high CV event rate. 

Presenting the findings in the Journal of Clinical Hypertension, the authors said the higher event rate with beta-blockers “may not necessarily be attributed to their lack of a protective effect but rather to pre‐existing conditions". They said the data support guidelines that do not recommend beta-blockers as first‐line monotherapy, especially without pre‐existing cardiac conditions.