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 .
Comparison of the effects of doxazosin and atenolol on target organ damage in adults with type 2 diabetes mellitus and hypertension in the CARDHIAC study: a 9-month, prospective, randomized, open-label, blinded-evaluation trial.
OBJECTIVE The CARDHIAC ( CARduran en pacientes Diabéticos con HIpertensi'on Arterial no Controlada ) trial examined the effects of doxazosin gastrointestinal therapeutic system ( GITS ) and atenolol on 3 separate measures of target-organ damage -- left ventricular mass index ( LVMI ) , carotid intima media thickness ( IMT ) , and urinary albumin excretion (UAE)--in  patients with type 2 diabetes mellitus and hypertension . METHOD This trial had a prospect i ve , open-label , blinded-evaluation design and a duration of 9 months . Patients whose blood pressure ( BP ) was uncontrolled ( systolic BP > or = 130 mm Hg and /or diastolic BP > or = 80 mm Hg ) despite at least 1 month of treatment with a renin-angiotensin blocker and diuretic  were r and omly allocated to receive doxazosin GITS 4 mg or atenolol 50 mg once daily in addition to their existing treatment . Seated BP was measured at study visits at 1 , 3 , 6 and 9 months ; if the BP goal was not achieved at any visit , the dose of doxazosin or atenolol was titrated upward to 8 or 100 mg , respectively . Treatment compliance ( pill count ) and adverse reactions were monitored at each visit . Each patient underwent echocardiography and Doppler ultrasonography at baseline and at the end of the study for evaluation of the change in LVMI . The change in carotid IMT was evaluated by carotid ultrasound examination at the same time points . UAE also was measured at baseline and the end of the study . RESULTS Sixty patients ( 100 % white ; 51 % female ; mean [ SD ] age , 63.4 [ 7.5 ] years ; body mass index , 28.2 [ 3.4 ] kg/m(2 ) ) were r and omized to receive doxazosin GITS ( n=32 ) or atenolol ( n=28 ) . At baseline , mean BP was 150.2 (10.6)/90.1 ( 7.3 ) mm Hg in the doxazosin group and 153.1 (13.8)/92.3 ( 6.1 ) mm Hg in the atenolol group ( P = NS ) . At the end of the study , BP had decreased by 10.1 (3.2)/5.2 ( 1.3 ) mm Hg in the doxazosin group and 12.2 (4.2)/6.3 ( 2.1 ) mm Hg in the atenolol group ( both , P<0.001 vs baseline ; P = NS between groups ) . Heart rate at the end of the study was 78(6 ) beats/min in the doxazosin group ( P = NS vs baseline ) and 66(7 ) beats/min in the atenolol group ( P<0.01 vs baseline and between groups ) . LVMI decreased by 10.8 in the doxazosin group ( P=0.001 vs baseline ) and 4.2 % in the atenolol group ( P = NS vs baseline ; P=0.03 between groups ) . The changes in carotid IMT and UAE were not statistically significant between groups . CONCLUSIONS In this study in hypertensive patients with type 2 diabetes , LVMI was significantly decreased in doxazosin-treated patients relative to baseline and compared with atenolol-treated patients . The differences in carotid IMT and UAE were not statistically significant between groups
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 .