Beta-Blockers for Hypertension May Raise Mortality Risks
Reduced heart rate in hypertensive patients using beta-blockers may increase cardiovascular event risks
THURSDAY, Oct. 23 (HealthDay News) -- Beta-blockers are not cardioprotective in patients treated for primary hypertension, and in fact, increase the risk for a number of cardiovascular events, according to a report in the Oct. 28 issue of the Journal of the American College of Cardiology.
Sripal Bangalore, M.D., of Columbia University College of Physicians and Surgeons in New York City, and colleagues performed a systematic review of 22 randomized controlled trials (RCTs) to determine if reducing heart rate with beta-blockers prevents cardiovascular events in hypertensive patients. Baseline characteristics, blood pressure response, baseline and end-of-trial heart rates, and cardiovascular outcomes were extracted from RCTs utilizing beta-blockers for first-line therapy for hypertension, having one year of follow-up, and having baseline and end-of-trial heart rate data.
In the 22 RCTs assessing beta-blockers for hypertension, only nine reported heart rate data with 34,096 patients taking beta-blockers compared to 30,139 patients taking alternative antihypertensive agents, the authors note. Lower heart rate was associated with a greater risk for all-cause mortality, cardiovascular mortality, myocardial infarction, stroke and heart failure, the researchers report.
"In contrast to patients with myocardial infarction, heart failure and known coronary artery disease, a slower heart rate with a beta-blocker was associated with increased risk of cardiovascular events and death among hypertensive patients: the slower the heart rate, the greater the risk," the authors conclude.
One of the study authors is a member of a number of speakers bureaus and has received funding/grants from pharmaceutical companies for his research.