Journal of Pharmacoeconomics and Pharmaceutical Management (Jul 2021)
Clinical Effects of Classical and Vasodilator Beta Blockers in Treating Hypertension in Adults: A Systematic Review
Abstract
Background: Beta-blockers are preferred anti-hypertensive for patients with compelling indications. Vasodilator beta-blockers are of particular benefit in blood pressure control and other cardio-metabolic components with limited disturbance in metabolic parameters. There is inadequate evidence on the superiority of vasodilator beta-blockers over non-vasodilator beta-blockers in treating hypertension. Therefore, this systematic review aimed to generate evidence on the clinical effects of non-vasodilator and vasodilator beta-blockers in treating hypertension in adults Methods: We searched articles in English published from January 2000 to January 2020 from the following databases: PubMed/Medline, Web of Science, and Google scholar. We considered the following search query: “clinical effectiveness AND vasodilator beta-blockers AND non-vasodilator beta-blockers AND adult hypertension treatment AND clinical trials”. Results: Nine randomized and controlled trials conducted in 3088 adult hypertensive patients were reviewed. All studies agreed on the comparable antihypertensive efficacy of vasodilating and non-vasodilating beta-blockers. Non-vasodilating beta-blockers significantly reduced heart rate, increased blood glucose, blood cholesterol, and triglycerides. Vasodilator beta-blockers were associated with better cardiometabolic risk reduction, better safety, and oxidative stress reduction. Conclusion: The hypertensive efficacy of vasodilating and non-vasodilating beta-blockers were comparable. Vasodilating beta-blockers were associated with better cardiometabolic risk reduction, better safety profile, and better oxidative stress reduction. However, there is insufficient evidence regarding the superiority of vasodilating and non-vasodilator betablockers. Therefore, it is essential to conduct comprehensive clinical trials by involving different ethnic groups to determine the benefit of vasodilator beta-blockers over non-vasodilators for treating hypertension.
