Beta Blockers Less Effective Against High Blood Pressure

But don't stop taking them, experts say

TUESDAY, Oct. 18, 2005 (HealthDay News) -- Beta blocker drugs are not as effective against high blood pressure as other medications, but they are better than nothing at all, a Swedish review of research reports.

Data from 13 trials that included more than 105,000 people showed the incidence of stroke was 16 percent higher and the overall death rate was 3 percent higher for those who took beta blockers compared to other drugs, according to a report by doctors at Umea University Hospital that appears in the Oct. 18 online issue of The Lancet.

But there was no increased risk of heart problems associated with beta blockers in those 13 trials. And seven other studies that compared beta blocker treatment of high blood pressure with no drug treatment at all found a 19 percent lower risk of stroke for those who took beta blockers.

"Switching hypertension treatment from beta blockers to other low-cost antihypertensive drugs in patients without heart disease should have a major health effect without increasing the cost," study author Dr. Lars Hjalmar Lindholm said in a statement. "Such a change, however, should be carried out slowly and under a doctor's supervision."

The Swedish report supports "a growing feeling among the scientific community that beta blockers may be not as good as other drugs," said Dr. Barry R. Davis, a professor of biostatistics at the University of Texas School of Public Health. "It adds a lot more strength to the concept that they shouldn't be used as first-line treatments."

Several studies have pointed away from beta blockers, Davis noted. One was the ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack) trial, whose results were reported earlier this year. They showed that diuretics, an older class of drugs that are inexpensive because they generally are available in generic form, are at least as effective as beta blockers, ACE inhibitors and calcium channel blockers in preventing heart problems and stroke.

But beta blockers will continue to be used against high blood pressure, said Dr. Daniel Jones, vice chancellor of the University of Mississippi Medical Center and a spokesman for the American Heart Association.

For one thing, he added, they have advantages for some people, like those with migraine or those who experience high blood pressure after a heart attack. And they almost always are prescribed along with another drug, such as a diuretic, he said.

Both Davis and Jones were emphatic on one point -- someone who is taking a beta blocker for high blood pressure should not be panicked by the report.

"Keep on taking it, and consult with your doctor," Davis said. "If it is the only drug you are taking, the doctor may consider prescribing another one."

"I emphasize that someone should not suddenly discontinue use of a beta blocker," Jones said. "There are risks to suddenly stopping the medication." The risks include "possible onset of angina or a heart attack and an elevation in blood pressure," he added.

Expert panels at organizations such as the American Heart Association "might rethink what they recommend" in the way of blood pressure medication because of the new report and previous studies, Davis said.

But, Jones said, "I see no immediate change in major guidelines."

More information

Facts about high blood pressure are provided by the American Heart Association.

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