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 .
Predischarge initiation of carvedilol in patients hospitalized for decompensated heart failure: results of the Initiation Management Predischarge: Process for Assessment of Carvedilol Therapy in Heart Failure (IMPACT-HF) trial.
OBJECTIVES The Initiation Management Predischarge : Process for Assessment of Carvedilol Therapy in Heart Failure ( IMPACT-HF ) trial was an investigator-initiated study to evaluate if predischarge carvedilol initiation in stabilized patients hospitalized for heart failure ( HF ) increased the number of patients treated with beta-blockade at 60 days after r and omization without increasing side effects or length of hospital stay . BACKGROUND Beta-blockers are underused in HF . Predischarge initiation may improve the use of evidence -based beta-blockade . METHODS The IMPACT-HF was a prospect i ve , r and omized open-label trial conducted in 363 patients hospitalized for HF . Patients were r and omized to carvedilol initiation pre-hospital discharge or to postdischarge initiation ( > 2 weeks ) of beta-blockade at the physicians ' discretion . The primary end point of the study was the number of patients treated with beta-blockade at 60 days after r and omization . Secondary end points included the number of patients discontinuing beta-blockade , median dose achieved , and a composite of death , rehospitalization , unscheduled visit for HF , or > or = 50 % increase in oral diuretic , new oral diuretic , or any intravenous therapy with diuretics , inotropes , or other vasoactive agents . RESULTS At 60 days 165 patients ( 91.2 % ) r and omized to predischarge carvedilol initiation were treated with a beta-blocker , compared with 130 patients ( 73.4 % ) r and omized to initiation postdischarge ( p < 0.0001 ) . Predischarge initiation was not associated with an increased risk of serious adverse events . The median length of stay was five days in both groups . CONCLUSIONS Predischarge initiation of carvedilol in stabilized patients hospitalized for HF improved the use of beta-blockade at 60 days without increasing side effects or length of stay . Predischarge initiation may be one approach to improve beta-blocker use in this population
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 .