Are there big differences among beta-blockers in treating essential hypertension?
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Yes, a number of beta-blockers are effective in lowering blood pressure (strength of recommendation [SOR]: A, multiple, consistent randomized controlled trials [RCTs]). Cardioselective beta-blockers do not alter lung function studies for patients with chronic obstructive pulmonary disease (COP D) or reversible airway disease (SOR: A, meta-analysis of RCTs). Propranolol and timolol have greater risks of causing fatigue as a side effect (SOR: A, meta- analysis of RCTs). Recent meta-analyses have stirred debate on the effectiveness of the agents in preventing adverse outcomes. The level of evidence has reached the point where the practice of using beta-blockers as monotherapy should be questioned (SOR : C, expert opinion).
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