β blockers switched to first-line therapy in hypertension.

Messerli, Franz H; Bangalore, Sripal; Mandrola, John M (2023). β blockers switched to first-line therapy in hypertension. The lancet, 402(10414), pp. 1802-1804. Elsevier 10.1016/S0140-6736(23)01733-6

Text 1-s2.0-S0140673623017336-main.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (257kB) | Request a copy

In their recent guidelines, the European Society of Hypertension upgraded β blockers, putting them on equal footing with thiazide diuretics, renin-angiotensin system blockers (eg, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers), and calcium channel blockers. The reason offered for upgrading β blockers was the observation that they are often used for many other clinical conditions commonly encountered with hypertension. This upgrade would allow for the treatment of two conditions with a single drug (a so-called twofer). In most current national and international hypertension guidelines, β blockers are only considered to be an alternative when there are specific indications. Compared with the other first-line antihypertensive drug classes, β blockers are significantly less effective in preventing stroke and cardiovascular mortality. To relegate β blockers to an inferiority status as previous guidelines have done was based on the evidence in aggregate, and still stands. No new evidence supports the switch of β blockers back to first-line therapy. We are concerned that this move might lead to widespread harm because of inferior stroke protection.

Interest & Impact

Downloads

0 since deposited on 18 Oct 2023
0 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item