Skip to main content
SpringerLink
Log in

Beta-Blocker Controversies

  • Chapter
Cardiac Drug Therapy

Part of the book series: Contemporary Cardiology ((CONCARD))

  • 1160 Accesses

Abstract

A metaanalysis by Lindholm et al. (1) concluded that beta-blockers should not remain the first choice in the treatment of primary hypertension. Unfortunately, this analysis included randomized controlled trials (RCTs) with poor methodology (see Chapter 9).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Lindholm LH, Carlberg B, Samuelsson O. Should β blockers remain first choice in the treatment of primary hypertension? A meta-analysis. Lancet 2005;366:1545–1553.

    Article  PubMed  CAS  Google Scholar 

  2. β blocker Heart Attack Trial Research Group. A randomised trial of propranolol in patients with acute myocardial infarction. I: Mortality results. JAMA 1982;247:1707–1714.

    Article  Google Scholar 

  3. Treatment of hypertension: The 1985 results. Lancet 1985;2:645–647.

    Google Scholar 

  4. Beta-Blocker Evaluation of Survival Trial Investigators. A trial of the beta-blocker bucindolol in patients with advanced chronic heart failure N Engl J Med 2001;62:1659–1667.

    Article  Google Scholar 

  5. Packer M, Fowler MB, Roecker EB, et al. Effect of carvedilol on the morbidity of patients with severe chronic heart failure: results of the Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) study. Circulation 2002;106:2194–2199.

    Article  PubMed  Google Scholar 

  6. The CAPRICORN Investigators. Effect of carvedilol on outcome after myocardial infarction in patients with left-ventricular dysfunction: The CAPRICORN randomised trial. Lancet 2001;357:1385–1390.

    Article  Google Scholar 

  7. CIBIS-II Investigators and Committees. The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): A randomised trial. Lancet 1999;353:9–13.

    Article  Google Scholar 

  8. MERIT-HF Study Group. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive heart failure (MERIT-HF). Lancet 1999;353:2001–2007.

    Article  Google Scholar 

  9. Cominacini L, Fratta Pasini A, Garbin U, et al. Nebivolol and its 4-keto derivative increase nitric oxide in endothelial cells by reducing its oxidative inactivation. J Am Coll Cardiol 2003;42:1838–1844.

    Article  PubMed  CAS  Google Scholar 

  10. Pitt B The role of beta-adrenergic blocking agents in preventing sudden cardiac death. Circulation 1992; 85(1 Suppl): 107.

    Google Scholar 

  11. Äblad B, Bjurö T, Björkman JA, Edström T, Olsson G. Role of central nervous beta-adrenoceptors in the prevention of ventricular fibrillation through augmentation of cardiac vagal tone. J Am Coll Cardiol 1991; 17(Suppl):165.

    Article  Google Scholar 

  12. Norwegian Multicentre Group. Timolol induced reduction in mortality and reinfarction in patients surviving acute myocardial infarction. N Engl J Med 1981;304:801–807.

    Article  Google Scholar 

  13. Neutel JM, Smith DHG, Ram CVS. Application of ambulatory blood pressure monitoring in differentiating between antihypertensive agents. Am J Med 1993;94:181.

    Article  PubMed  CAS  Google Scholar 

  14. Kokkinos P, Chrysohoou C, Panagiotakos D, et al. Beta-blockade mitigates exercise blood pressure in hypertensive male patients. J Am Coll Cardiol 2006;47:794–798.

    Article  PubMed  CAS  Google Scholar 

  15. CAFE investigators for the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) investigators. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: Principal results of the Conduit Artery Function Evaluation (CAFE) Study. Circulation 2006; 113:1213–1225.

    Article  CAS  Google Scholar 

  16. Dahlof B, Sever PS, Poulter NR, et al. for the ASCOT investigators. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): A multicentre randomised controlled trial. Lancet 2005;366:895–906.

    Article  PubMed  CAS  Google Scholar 

  17. Khan M Gabriel. Hypertension. In: Cardiac Drug Therapy, 6th ed. Philadelphia, WB Saunders, 2003; 46–48.

    Google Scholar 

  18. Khan M Gabriel. Which beta blocker to choose. In: Heart Disease Diagnosis and Therapy, a Practical Approach, 2nd ed. Totowa, NJ, Humana Press, 2005, pp. 311–314.

    Google Scholar 

  19. Messerli FH, Grossman E, Goldbourt U. Are P-blockers efficacious as first-line therapy for hypertension in the elderly? JAMA 1998;279:1903–1907.

    Article  PubMed  CAS  Google Scholar 

  20. MRC Working Party. Medical Research Council Trial of treatment of hypertension in older adults: Principal results. BMJ 1992;304:405–412.

    Article  Google Scholar 

  21. Loubatiere A, Mariani MM, Sorel G, et al. The action of beta adrenergic blocking drugs and stimulating agents on insulin secretion. Characteristic of the type of beta receptor. Diabetologica 1971;7:127–132.

    Article  Google Scholar 

  22. UK Prospective Diabetes Study Group. Efficacy of atenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS. BMJ 1998;317:713–720.

    Google Scholar 

  23. Gress TW, Nieto FJ, Shahar E, et al. for The Atherosclerosis Risk in Communities Study: Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. N Engl J Med 2000;342:905–912.

    Article  PubMed  CAS  Google Scholar 

  24. Padwal R, Laupacis A. Antihypertensive therapy and incidence of type 2 diabetes. A systematic review. Diabetes Care 2004;27:247–255.

    Article  PubMed  Google Scholar 

  25. Lindholm LH, Ibsen H, Borch-Johnsen K, et al. Risk of new-onset diabetes in the Losartan Intervention For Endpoint reduction in hypertension study. J Hypertens 2002;20:1879–1886.

    Article  PubMed  CAS  Google Scholar 

  26. Hansson L, Lindholm LH, Ekbom T, et al. Randomised trial of old and new antihypertensive drugs in elderly patients: cardiovascular mortality and morbidity. The S wedish Trial in Old Patients with Hypertension-2 study. Lancet 1999;354:1751–1756.

    Article  PubMed  CAS  Google Scholar 

  27. Murphy MB, Lewis PJ, Kohner E, Schumerz B, Dollery CT. Glucose intolerance in hypertensive patients treated with diuretics: A fourteen-year follow-up. Lancet 1982;2:1293–1295.

    Article  PubMed  CAS  Google Scholar 

  28. GEMINI: Bakris GL, Fonseca V, Katholi RE, et al. Metabolic effects of carvedilol vs metoprolol in patients with type 2 diabetes mellitus and hypertension: arandomized controlled trial. JAMA 2004;292: 2227–2236.

    Article  PubMed  CAS  Google Scholar 

  29. Giugliano D, Acampora R, Marfella R, et al. Metabolic and cardiovascular effects of carvedilol and atenolol in non-insulin-dependent diabetes mellitus and hypertension: a randomized, controlled trial. Ann Intern Med 1997;126:955–959.

    PubMed  CAS  Google Scholar 

  30. COMMIT (Clopidogrel and Metoprolol in Myocardial Infarction Trial) Collaborative Group. Early intravenous then oral metoprolol in 45,852 patients with acute myocardial infarction: Randomised placebocontrolled trial. Lancet 2005;366:1622–1632.

    Article  CAS  Google Scholar 

Suggested Reading

  • Remme WJ, Torp-Pedersen C, Cleland JGF, et al. Carvedilol protects better against vascular events than metoprolol in heart failure: results from COMET. J Am Coll Cardiol 2007;49:963–971.

    Article  PubMed  CAS  Google Scholar 

Download references

Rights and permissions

Reprints and permissions

Copyright information

© 2007 HumanaPress Inc., Totowa, NJ

About this chapter

Cite this chapter

(2007). Beta-Blocker Controversies. In: Cardiac Drug Therapy. Contemporary Cardiology. Humana Press. https://doi.org/10.1007/978-1-59745-238-0_2

Download citation

  • DOI: https://doi.org/10.1007/978-1-59745-238-0_2

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-904-8

  • Online ISBN: 978-1-59745-238-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation