Comparative Effectiveness of 2 beta-Blockers in Hypertensive Patients

摘要

Background: Randomized controlled trials have demonstrated the efficacy of selected beta-blockers for preventing cardiovascular (CV) events in patients following myo-cardial infarction (MI) or with heart failure (HF). However, the effectiveness of beta-blockers for preventing CV events in patients with hypertension has been questioned recently, but it is unclear whether this is a class effect. Methods: Using electronic medical record and health plan data from the Cardiovascular Research Network Hypertension Registry, we compared incident MI, HF, and stroke in patients who were new beta-blocker users between 2000 and 2009. Patients had no history of CV disease and had not previously filled a prescription for a 3-blocker. Cox proportional hazards regression was used to examine the associations of atenolol and metoprolol tartrate with incident CV events using both standard co-variate adjustment (n= 120 978) and propensity score-matching methods (n=22352).