Atenolol  was the beta‐blocker most used .
Current evidence suggests that initiating treatment of hypertension with beta‐blockers leads to modest CVD reductions and little or no effects on mortality .
These beta‐blocker effects are inferior to those of other antihypertensive drugs .
Abstract Background Beta‐blockers refer to a mixed group of drugs with diverse pharmacodynamic and pharmacokinetic properties .
They have shown long‐term beneficial effects on mortality and cardiovascular disease ( CVD ) when used in people with heart failure or acute myocardial infa rct ion .
Beta‐blockers were thought to have similar beneficial effects when used as first‐line therapy for hypertension .
However , the benefit of beta‐blockers as first‐line therapy for hypertension without compelling indications is controversial .
This review is an up date of a Cochrane Review initially published in 2007 and up date d in 2012 .
Objectives To assess the effects of beta‐blockers on morbidity and mortality endpoints in adults with hypertension .
Controlling hypertension and hypotension immediately post-stroke (CHHIPS): a randomised, placebo-controlled, double-blind pilot trial
BACKGROUND Raised blood pressure is common after acute stroke and is associated with an adverse prognosis . We sought to assess the feasibility , safety , and effects of two regimens for lowering blood pressure in patients who have had a stroke . METHODS Patients who had cerebral infa rct ion or cerebral haemorrhage and were hypertensive ( systolic blood pressure [ SBP ] > 160 mm Hg ) were r and omly assigned by secure internet central r and omisation to receive oral labetalol , lisinopril , or placebo if they were non-dysphagic , or intravenous labetalol , sublingual lisinopril , or placebo if they had dysphagia , within 36 h of symptom onset in this double-blind pilot trial . The doses were titrated up if target blood pressure was not reached . Analysis was by intention to treat . This trial is registered with the National Research Register , number N0484128008 . FINDINGS 179 patients ( mean age 74 [ SD 11 ] years ; SBP 181 [ SD 16 ] mm Hg ; diastolic blood pressure [ DBP ] 95 [ SD 13 ] mm Hg ; median National Institutes of Health stroke scale [ NIHSS ] score 9 [ IQR 5 - 16 ] points ) were r and omly assigned to receive labetolol ( n=58 ) , lisinopril ( n=58 ) , or placebo ( n=63 ) between January , 2005 , and December , 2007 . The primary outcome --death or dependency at 2 weeks -- occurred in 61 % ( 69 ) of the active and 59 % ( 35 ) of the placebo group ( relative risk [ RR ] 1.03 , 95 % CI 0.80 - 1.33 ; p=0.82 ) . There was no evidence of early neurological deterioration with active treatment ( RR 1.22 , 0.33 - 4.54 ; p=0.76 ) despite the significantly greater fall in SBP within the first 24 h in this group compared with placebo ( 21 [ 17 - 25 ] mm Hg vs 11 [ 5 - 17 ] mm Hg ; p=0.004 ) . No increase in serious adverse events was reported with active treatment ( RR 0.91 , 0.69 - 1.12 ; p=0.50 ) but 3-month mortality was halved ( 9.7%vs 20.3 % , hazard ratio [ HR ] 0.40 , 95 % CI 0.2 - 1.0 ; p=0.05 ) . INTERPRETATION Labetalol and lisinopril are effective antihypertensive drugs in acute stroke that do not increase serious adverse events . Early lowering of blood pressure with lisinopril and labetalol after acute stroke seems to be a promising approach to reduce mortality and potential disability . However , in view of the small sample size , care must be taken when these results are interpreted and further evaluation in larger trials is needed
Atenolol  was the beta‐blocker most used .
Current evidence suggests that initiating treatment of hypertension with beta‐blockers leads to modest CVD reductions and little or no effects on mortality .
These beta‐blocker effects are inferior to those of other antihypertensive drugs .
Abstract Background Beta‐blockers refer to a mixed group of drugs with diverse pharmacodynamic and pharmacokinetic properties .
They have shown long‐term beneficial effects on mortality and cardiovascular disease ( CVD ) when used in people with heart failure or acute myocardial infa rct ion .
Beta‐blockers were thought to have similar beneficial effects when used as first‐line therapy for hypertension .
However , the benefit of beta‐blockers as first‐line therapy for hypertension without compelling indications is controversial .
This review is an up date of a Cochrane Review initially published in 2007 and up date d in 2012 .
Objectives To assess the effects of beta‐blockers on morbidity and mortality endpoints in adults with hypertension .