beta blockers
DISEASE INTERVENTION COMPARISON RESULTS
Eur Heart J. 2007 Dec;28(24):3012-9 Meta-Analysis
IN coronary disease, myocardial infarction The Use of
further reduction of resting heart rate using beta blockers (or calcium channel blockers)
As Treatment, Chronic
Is better Than
less important reduction of resting herat rate
To reduce cardiac mortality: each 10 b.p.m. reduction estimated to reduce the relative risk of cardiac death by 30%
JAMA. 1999 May 26;281(20):1927-36 Meta-Analysis
IN coronary disease, stable angina The Use of
beta blockers
As Treatment, Chronic
Is better Than
calcium channel blockers
To reduce number of angina episodes (OR 0.31). But no significant differences in rates of death or myocardial infarction.
N Engl J Med. 1991 May 30;324(22):1532-8 Meta-Analysis
IN gastrointestinal bleeding, upper, oesophageal varices The Use of
beta blockers
As Prevention
Is Than
To
N Engl J Med. 1999 Apr 1;340(13):988-93 Randomized? Controlled Trial
IN gastrointestinal bleeding, upper, oesophageal varices The Use of
beta blockers, tto endoscópico, ligadura
As Prevention
Is Than
To
J Hepatol. 1997 Feb;26(2):312-24 Systematic Review
IN gastrointestinal bleeding, upper, oesophageal varices The Use of
beta blockers, tratamiento endoscópico, esclerosis
As Treatment, Chronic
Is Than
To
Eur Heart J. 2009 Sep;30(18):2186-92 Randomized Controlled Trial
IN heart failure, acute, systolic The Use of
maintaining previous Tt with beta blockers
As Treatment, Acute
Is equal Than
stoping it during the acute phase of decompensation
To improve dyspnoea and symptoms at 3 days (92.8% maintain VS 92.3% stop), at 8 days and death at 3 months. More patients continuing beta-blockers received it 3 months after (90% VS 76% when stoped)
Cochrane Database Syst Rev. 2018 06 28;6():CD012721 Systematic Review, Cochrane Review
IN heart failure, chronic, diastolic (preserved ejection fraction) The Use of
various medical treatments: angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), beta blockers, aldosterone blockers, spironolactone
As Treatment, Chronic
Is undefined Than
placebo
To Aldosterone blockers reduce heart failure hospitalisations (11% aldost blockers VS 14% controls). Beta-blockers might reduce cardiovascular mortality (15% BB VS 19% placebo) but inconsistent evidence. ACEI and ARB did not seem to have any effect
Heart. 2018 Mar;104(5):407-415 Meta-Analysis
IN heart failure, chronic, diastolic (preserved ejection fraction) The Use of
various medical treatments: angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), beta blockers, aldosterone blockers, spironolactone
As Treatment, Chronic
Is equal Than
placebo
To modify survival (except beta blockers, associated with reduced all-cause and cardiac deaths, (RR: 0.78) or reduce rehospitalizations or improve functional capacity
J Am Coll Cardiol. 2011 Apr 19;57(16):1676-86 Meta-Analysis
IN heart failure, chronic, diastolic (preserved ejection fraction) The Use of
various medical treatments: angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), beta blockers, others
As Treatment, Chronic
Is better Than
placebo ou usual care without those treatments
To improve excercise tolerance (51 to 61 more seconds on treadmill excercise test) but not heart fonction (E/A ratio) nor mortality
Heart. 2017 Aug 5. doi: 10.1136/heartjnl-2017-311652. [Epub ahead of prin Systematic Review
IN heart failure, chronic, diastolic (preserved ejection fraction) The Use of
various medical treatments: angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), beta blockers, others
As Treatment, Chronic
Is equal Than
placebo ou usual care without those treatments
To modify mortality, with the exception of beta-blockers (RR 0.78). Trend to improve, but non consistent results, exercise capacity and quality of life
J Am Coll Cardiol. 2009 Jun 9;53(23):2150-8 Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic, diastolic (preserved ejection fraction), elder patients The Use of
beta blockers, nebivolol (Temerit TM)
As Treatment, Chronic
Is better Than
placebo
To reduce, at 21 months, a composite of all-cause mortality or cardiovascular hospitalizations equally in patients with preserved EF and in those with reduced EF.
Eur Heart J. 2005 Feb;26(3):215-25 Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic, diastolic (preserved ejection fraction), systolic, elder patients The Use of
beta blockers, nebivolol (Temerit TM)
As Treatment, Chronic
Is better Than
placebo
To reduce, at 21 months, a composite of death from all causes and cardiovascular hospital admission: 31% nebivolol VS 35% placebo. There were a non-significant reduction of death: 16% nebivolol VS 18% placebo.
J Am Coll Cardiol. 2007 Mar 6;49(9):963-71 Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic, systolic The Use of
beta blockers, carvedilol
As Treatment, Acute
Is better Than
beta blockers, metoprolol
To reduce myocardial infarction (HR 0.71), unstable angina (HR 0.71) and fatal infarction or stroke (HR 0.46)
Circulation. 1998;98:1184-1191. Meta-Analysis
IN heart failure, chronic, systolic The Use of
beta blockers
As Treatment, Chronic
Is Than
To
N Engl J Med. 1996 May 23;334(21):1349-55 Randomized Controlled Trial
IN heart failure, chronic, systolic The Use of
beta blockers, carvedilol
As Treatment, Chronic
Is better Than
placebo
To reduces the risk or death and of hospitalization
Lancet. 1997 Feb 8;349(9049):375-80 Randomized Controlled Trial
IN heart failure, chronic, systolic The Use of
beta blockers, carvedilol
As Treatment, Chronic
Is better Than
placebo
To reduce death or hospitalization
JAMA. 2000 Mar 8;283(10):1295-302 Randomized Controlled Trial
IN heart failure, chronic, systolic The Use of
beta blockers, metoprolol
As Treatment, Chronic
Is better Than
placebo
To reduce all-cause death or hospital admission: metoprolol 32% vs. placebo 38%
BMJ. 2009 May 19;338:b1665. doi: 10.1136/bmj.b1665 Meta-Analysis
IN hypertension, primary The Use of
5 main classes of blood pressure lowering drugs: thiazides, beta blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel blockers
As Treatment, Chronic
Is better Than
placebo
To Prevent cardiac ischemic events, heart failure and stroke. Beta-blockers prevent better cardiac ischemis events after a myocardial infarction. Calcium antagonist had a marginal advantage for preventing stroke.
Lancet. 2005 Oct 29-Nov 4;366(9496):1545-53 Meta-Analysis
IN hypertension, primary The Use of
beta blockers
As Treatment, Chronic
Is worse Than
other first choice antihypertensives
To prevent stroke (RR 16% higher with beta-blockers than other drugs), myocardial infarction or overall mortality (no significant difference in AMI and mortality compared with placebo)
Cochrane Database Syst Rev. 2012 Nov 14;11:CD002003. doi: 10.1002/14651858.CD002003.pub4 Systematic Review, Cochrane Review
IN hypertension, primary The Use of
beta blockers, mainly atenolol
As Treatment, Chronic
Is worse Than
placebo or other first choice antihypertensives
To modify the risk of total mortality or coronary disease (not different to placebo), stroke (reduced compared to placebo but increased compared to CCB and RAS inhibitors)
Lancet. 2008 May 31;371(9627):1839-47 Randomized Controlled Trial, Multicenter Study
IN surgical risk, major non cardiac surgery The Use of
beta blockers, metoprolol, peri-operative
As Prevention, Primary
Is worse Than
placebo
To reduce perioperative mortality (3.1% beta-blocker VS 2.3% placebo) or reduce stroke (1% beta-blocker VS 0.5% placebo), even if it reduced myocardial infarction (4.2% beta-blocker VS 5.7% placebo)