3/17/2021 0 Comments 1 Blocker 1 4 7 Review
Overall, the majority of beta-1 blockers studied significantly lowered systolic blood pressure (SBP) and diastolic blood pressure (DBP).
![]() These participants were randomly assigned to receive a fixed dose of beta-1 blocker treatment or placebo for 3 weeks to 12 weeks. In general, higher doses of beta-1 blockers did not show greater reduction of blood pressure compared to lower doses. ![]() Beta-1 selective blockers lower systolic and diastolic BP to a similar degree, as is the case for the other subclasses of beta blockers, and thus have little or no effect on pulse pressure. This is different from other classes of antihypertensive drugs, such as thiazide diuretics, angiotensin converting enzyme inhibitors and angiotensin receptor blockers. A low quality of evidence means future research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. The effect of beta-1 blockers at peak hours, -12-9 mmHg, was greater than the reduction at trough hours, -8-7 mmHg. Beta-1 selective blockers lowered BP by a greater magnitude than dual receptor beta-blockers and partial agonist beta-blockers, lowered BP similarly to nonselective beta-blockers. Beta-1 selective blockers lowered SBP by a similar degree and lowered DBP by a greater degree than diuretics, angiotensin converting enzyme inhibitors and angiotensin receptor blockers. Because DBP is lowered by a similar extent to SBP, beta-1 selective blockers do not reduce pulse pressure. The blood pressure reading is the primary tool for physicians and patients to assess the efficacy of the treatment. The blood pressure lowering effect of beta-1 selective blockers is not known. Objectives: To quantify the dose-related effects of various doses and types of beta-1 selective adrenergic receptor blockers on systolic and diastolic blood pressure versus placebo in people with primary hypertension. Search strategy: We searched the Database of Abstracts of Reviews of Effectiveness (DARE) for related reviews. The MEDLINE search strategy was translated into CENTRAL, EMBASE, the Hypertension Group Specialised Register and ClinicalTrials.gov using the appropriate controlled vocabulary as applicable. Selection criteria: Randomised, double- blind, placebo -controlled parallel or cross-over trials. Studies had to contain a beta blocker monotherapy arm with fixed dose. People enrolled into the studies had to have primary hypertension at baseline. Drugs in this class of beta blockers are atenolol, betaxolol, bevantolol, bisoprolol, esmolol, metoprolol, nebivolol, pafenolol, practolol. Data collection and analysis: Two authors confirmed the inclusion of studies and extracted the data independently. ![]() Among the included trials, 26 RCTs were parallel studies and 30 RCTs were cross-over studies, examining eight beta-1 blockers.
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