Why β-blockers are not cardioprotective in elderly patients with hypertension
Author:
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine
Link
http://link.springer.com/content/pdf/10.1007/s11886-002-0108-3.pdf
Reference70 articles.
1. The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure [see comments] [published erratum appears in Arch Intern Med 1998, 158:573]. Arch Intern Med 1997, 157:2413–2446.
2. Messerli FH, Grossman E, Goldbourt U: Are beta-blockers efficacious as first-line therapy for hypertension in the elderly? A systematic review. JAMA 1998, 279:1903–1907. Meta-analysis of prospective randomized studies in the elderly showed that diuretic therapy was superior to β-blockade with regard to all endpoints, and was effective in preventing cerebrovascular events, fatal stroke, coronary heart disease, cardiovascular mortality, and all-cause mortality. In contrast, β-blocker therapy only reduced the odds for cerebrovascular events, but was ineffective in preventing coronary heart disease, cardiovascular mortality, and all-cause mortality.
3. Medical Research Council trial of treatment of hypertension in older adults: principal results. MRC Working Party. BMJ 1992, 304:405–412. Elderly hypertensive patients were randomized to receive a diuretic, β-blocker, or placebo. The diuretic-treated group had significantly reduced risks of stroke, coronary events, and all cardiovascular events compared with the placebo group. The β-blocker group showed no significant reductions in these endpoints.
4. Lever AF, Brennan PJ: MRC trial of treatment in elderly hypertensives. Clin Exp Hypertens 1993, 15:941–952.
5. Dahlof B, Devereux RB, Kjeldsen SE et al.: Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002, 359:995–1003. This is a report of the double-masked, randomized, parallel-group trial of 9193 participants aged 55 to 80 years with essential hypertension and LVH ascertained by ECG. Participants were assigned once daily losartan-based or atenolol-based antihypertensive treatment for at least 4 years. Losartan prevented more cardiovascular morbidity and death than atenolol for a similar reduction in blood pressure and was better tolerated.
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