Cochrane corner: beta-blockers for hypertension

BaCkground Beta-blockers refer to an assorted group of medications that block the action of endogenous catecholamines on beta-adrenergic receptors. The β1 and β2 receptors are the primary beta-adrenergic receptors in the human cardiovascular system. Betablockers differ in their β1/β2-receptor selectivity and vasodilatory properties. Based on this diversity, beta-blockers have been categorised into first, second and third generation. First-generation betablockers, also referred to as non-selective blockers, possess equal affinity for β1 and β2 receptors. Second-generation (or selective) beta-blockers exercise more affinity for β1 than β2 receptors. Neither of these traditional beta-blockers has vasodilatory properties, which is an intrinsic characteristic of third-generation beta-blockers. Beta-blockers have been known to play a role in blood pressure control since 1949. We summarise the findings of a Cochrane Review we published in 2017 on the comparative effects of beta-blockers as initial treatment for hypertension. This is an update of a review we first published 10 years ago.