Should blockers remain first choice in the treatment of primary hypertension? A meta-analysis

Introduction For three decades, blockers have been widely used in the treatment of hypertension and are still recommended as first-line drugs in hypertension guidelines. Moreover, after myocardial infarction and in patients with heart failure, treatment with blockers prevents re-infarction, hospitalisation for heart failure, and premature death. The effect of blockers as a treatment for primary hypertension has been challenged. A preliminary analysis has shown that atenolol is not very effective in hypertension. 9 To avoid unnecessary harm to patients, the role of other blockers needs to be investigated. Here, we substantially enlarge the data on atenolol and analyse the effect of different blockers on stroke, myocardial infarction, and mortality of all causes (n=127879).