When the blood pressure lowering effect of beta-blockers from this review was compared to that of thiazide diuretics from our previous review ( Chen 2009 ) , second-line beta-blockers reduce systolic BP to the same extent as second-line thiazide diuretics , but reduce diastolic BP to a greater degree .
The different effect on diastolic BP means that beta-blockers have little or no effect on pulse pressure whereas thiazides cause a significant dose-related decrease in pulse pressure .
This difference in the pattern of BP lowering with beta-blockers as compared to thiazides might be the explanation for the fact that beta-blockers appear to be less effective at reducing adverse cardiovascular outcomes than thiazide diuretics , particularly in older individuals
BACKGROUND Beta-blockers are one of the more commonly prescribed classes of anti-hypertensive drugs , both as first-line and second-line .
OBJECTIVES To quantify the effect on systolic blood pressure ( SBP ) , diastolic blood pressure ( DBP ) , heart rate and withdrawals due to adverse effects of beta-blocker therapy when given as a second-line drug in adult patients with primary hypertension .
Resting heart rate is a risk factor for cardiovascular and noncardiovascular mortality: the Chicago Heart Association Detection Project in Industry.
In a prospect i ve cohort study , associations of resting heart rate with  risk of coronary , cardiovascular disease , cancer , and all-cause mortality in age-specific cohorts of black and white men and women were examined over 22 years of follow-up . Participants were employees from 84 companies and organizations in the Chicago , Illinois , area who volunteered for a screening examination . Participants included 9,706 men aged 18 - 39 years , 7,760 men aged 40 - 59 years , 1,321 men aged 60 - 74 years , 6,928 women aged 18 - 39 years , 6,915 women aged 40 - 59 years , and 1,151 women aged 60 - 74 years at the baseline examination in 1967 - 1973 . Vital status was ascertained through 1992 . For fatal coronary disease , multivariate-adjusted relative risks associated with a 12 beats per minute higher heart rate ( one st and ard deviation ) were as follows : for men aged 18 - 39 years , relative risk ( RR ) = 1.27 ( 95 % confidence interval ( CI ) 1.08 - 1.48 ) ; for men aged 40 - 59 years , RR = 1.13 ( 95 % CI 1.05 - 1.21 ) ; for men aged 60 - 74 years , RR = 1.00 ( 95 % CI 0.89 - 1.12 ) ; for women aged 40 - 59 years , RR = 1.21 ( 95 % CI 1.07 - 1.36 ) ; and for women aged 60 - 74 years , RR = 1.16 ( 95 % CI 0.99 - 1.37 ) . Corresponding risks for all fatal cardiovascular diseases were similar to those for coronary death alone . Deaths from cancer were significantly associated with heart rate in men and women aged 40 - 59 years . All-cause mortality was associated with higher heart rate in men aged 18 - 39 years ( RR = 1.11 , 95 % CI 1.01 - 1.20 ) , men aged 40 - 59 years ( RR = 1.16 , 95 % CI 1.11 - 1.21 ) , and women aged 40 - 59 years ( RR = 1.20 , 95 % CI 1.13 - 1.27 ) . Heart rate was not associated with mortality in women aged 18 - 39 years . In summary , heart rate was a risk factor for mortality from coronary disease , all cardiovascular diseases , and all causes in younger men and in middle-aged men and women , and for cancer mortality in middle-aged men and women
When the blood pressure lowering effect of beta-blockers from this review was compared to that of thiazide diuretics from our previous review ( Chen 2009 ) , second-line beta-blockers reduce systolic BP to the same extent as second-line thiazide diuretics , but reduce diastolic BP to a greater degree .
The different effect on diastolic BP means that beta-blockers have little or no effect on pulse pressure whereas thiazides cause a significant dose-related decrease in pulse pressure .
This difference in the pattern of BP lowering with beta-blockers as compared to thiazides might be the explanation for the fact that beta-blockers appear to be less effective at reducing adverse cardiovascular outcomes than thiazide diuretics , particularly in older individuals
BACKGROUND Beta-blockers are one of the more commonly prescribed classes of anti-hypertensive drugs , both as first-line and second-line .
OBJECTIVES To quantify the effect on systolic blood pressure ( SBP ) , diastolic blood pressure ( DBP ) , heart rate and withdrawals due to adverse effects of beta-blocker therapy when given as a second-line drug in adult patients with primary hypertension .