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 .
Antihypertensive efficacy of zofenopril compared with atenolol in patients with mild to moderate hypertension
Two first‐line antihypertensive therapies for initiating treatment in hypertension were compared , the angiotensin‐converting enzyme inhibitor ( ACEI ) zofenopril and the beta‐blocker atenolol . The study was multi‐centre and double‐blind , and included 304 middle‐aged to elderly patients with mild to moderate hypertension who were r and omized to receive either zofenopril 30–60 mg once daily ( od ) or atenolol 50–100 mg od for 4 weeks with the possibility to an up‐titration in non‐responding patients . The higher dose level was then administered until 12 weeks after r and omization . Blood pressures ( BPs ) were substantially reduced by either treatment , but after 4 weeks , the systolic and diastolic BP reductions were significantly greater ( p<0.05 ) with zofenopril ( −15.6/−13.5 mmHg ) compared with atenolol ( −13.1/−11.8 mmHg ) . After 12 weeks and the possibility of dose up‐titration , BP differences between treatments were no longer significant . However , control rates ( sitting diastolic BP < 90 mmHg ) for zofenopril remained significantly higher compared with atenolol .  The number of subjects with adverse drug reactions possibly or probably related to the study medication was 14 ( 9.1 % ) in the zofenopril group and 30 ( 20.8 % ) in the atenolol group ( p = 0.008 ) . It is concluded that zofenopril as well as atenolol induces substantial reductions of diastolic BP in middle‐aged to elderly patients with hypertension . However , the control rate when initiating antihypertensive therapy with zofenopril is higher than that for atenolol
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 .