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 .
Risk factors associated with alterations in carotid intima—media thickness in hypertension: baseline data from the European Lacidipine Study on Atherosclerosis
Background The possibility that calcium antagonists exert an anti-atherosclerotic action at least partly independently of the blood-pressure-lowering effect is supported by results of a large number of experimental studies and can now be investigated by quantitative β-mode ultrasound imagining of the carotid artery walls . Design The European Lacidipine Study on Atherosclerosis ( ELSA ) is a prospect i ve , r and omized , double-blind , multinational trial comparing effects of 4-year treatment based on the long-acting , highly lipophilic calcium antagonist lacidipine with those of treatment based on the β-blocker atenolol on the development of carotid artery wall alterations in patients ( aged 45–75 years ) with mild-to-moderate hypertension ( systolic blood pressure 150–210 mmHg and diastolic blood pressure 95–115 mmHg ) . While the intervention study is progressing , this article summarizes baseline data obtained from the whole cohort of 2259 patients r and omly allocated to treatment . Methods Baseline ultrasound data were obtained from two replicate examinations performed shortly before r and om allocation to treatment by certified sonographers at 23 referral centres and read at the ultrasound coordinating centre at the Wake Forest University School of Medicine  . Intima — media thickness was measured at up to 12 different sites in the carotid artery tree and expressed as the mean of the maxima at these sites ( Mmax ) , the mean of the maxima at four sites in the distal common carotid artery and bifurcation ( CBMmax ) and the maximum intima — media thickness ( Tmax ) . Baseline demographic and clinical measurements were performed by investigators in 410 peripheral clinical units and 24 h ambulatory blood pressure monitorings read and vali date d by members of a central ized unit at the University of Milan . The statistical analysis centre at the Technische Universität Mächen received and analysed all baseline data , by calculating means ± SD , medians and ranges and performing correlation ( Spearman correlation coefficients ) and multiple regression analyses . Results Prevalence of carotid artery wall alterations among the hypertensive patients r and omly allocated to treatment in the ELSA was very high : 82 % had Tmax > 1.3 mm ( ‘ plaques ’ according to protocol ) and 17 % had Tmax > 1.0 and < 1.3 mm ( ‘ thickening ’ ) , with a median of two plaques per patient . We found significant correlations between ultrasound measurements and the following demographic and clinical variables : age , sex , systolic blood pressure and pulse pressure ( both clinic and ambulatory ) , concentrations of total , high-density lipoprotein and low-density lipoprotein cholesterol and triglycerides , smoking habit and duration of hypertension . We found no significant correlation to diastolic blood pressure and glucose concentration . A multiple regression analysis indicated significant variables in the following rank order : age , 24 h ambulatory pulse pressure , sex , low-density lipoprotein cholesterol concentration , triglyceride concentration , smoking and clinic systolic blood pressure . Conclusions Analysis of baseline data from the ELSA has shown that there is an extremely marked prevalence of carotid artery wall alterations among mild-to-moderate , middle-aged hypertensive patients . In addition to age , systolic blood pressure and pulse pressure , particularly if they are accurately measured by ambulatory monitoring , play a major role , somewhat greater than those of sex , low-density lipoprotein cholesterol concentration and smoking , in influencing intima — media thickness
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 .