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Cochrane corner: beta-blockers for hypertension
  1. Charles S Wiysonge1,
  2. Hazel A Bradley2,
  3. Jimmy Volmink3,
  4. Bongani M Mayosi4,5
  1. 1Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
  2. 2School of Public Health, University of the Western Cape, Cape Town, South Africa
  3. 3Centre for Evidence-Based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
  4. 4Department of Medicine, University of Cape Town, Cape Town, South Africa
  5. 5Groote Schuur Hospital, Cape Town, South Africa
  1. Correspondence to Charles S Wiysonge, Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley 7501, Cape Town, South Africa; Charles.Wiysonge{at}mrc.ac.za

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Background

Beta-blockers refer to an assorted group of medications that block the action of endogenous catecholamines on beta-adrenergic receptors.1 The β1 and β2 receptors are the primary beta-adrenergic receptors in the human cardiovascular system. Beta-blockers 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 beta-blockers, 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.2

Beta-blockers have been known to play a role in blood pressure control since 1949.3 We summarise the findings of a Cochrane Review we published in 2017 on the comparative effects of beta-blockers as initial treatment for hypertension.4 This is an update of a review we first published 10 years ago.5–7

Concise methods

We searched the Cochrane Library, MEDLINE, EMBASE and ClinicalTrials.gov using a comprehensive database-specific …

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