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CMAJ • July 25, 2000; 163 (2)
© 2000 Canadian Medical Association or its licensors

Review
Synthèse

Choosing a first-line drug in the management of elevated blood pressure: What is the evidence? 2: ß-Blockers

James M. Wright

Dr. Wright is Professor, Departments of Medicine and Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC.

Abstract

ELEVATED BLOOD PRESSURE IS ASSOCIATED WITH an increased risk of cardiovascular illness and death. Efforts to reduce that risk have led to recommendations for a wide array of nondrug and drug therapies. Choosing the optimal first-line drug for hypertensive patients should address a hierarchy of treatment goals: decrease in morbidity and mortality associated with hypertension, decrease in blood pressure, good tolerance, dosing convenience and low cost. This article examines the evidence for ß-blockers as a class of first-line antihypertensive drugs in light of these treatment goals. The evidence indicates that ß-blockers are probably not as effective in reducing morbidity and mortality as low-dose thiazide diuretics and that there may be significant differences in effectiveness among various ß-blockers.




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