The Cochrane Library, 2007, Issue 1

Beta blockers are less effective than other drugs for first-line treatment of high blood pressure
Beta blocker drugs are commonly used in the initial attempts to lower blood pressure. However a Cochrane Review shows that they were not as good at reducing death or the severity of disease as other classes of drugs. Drugs that perform better include thiazides, calcium channel blockers and renin angiotensin system inhibitors.

Starting with the best therapy is important because even a modest reduction of blood pressure in people with hypertension can significantly reduce their risk of suffering from stroke or cardiovascular disease.

The Cochrane Review gathered data from 13 different randomized controlled trials that together involved over 91,000 participants. The effect of beta blockers was not significantly different from placebo in terms of total mortality or coronary heart disease. Beta blockers did, however, reduce the risk of stroke by 0.5% when compared to placebo, but in trials that compared beta blockers with calcium channel blockers (CCB), patients on CCB drugs had fewer strokes.

"The available evidence does not support the use of beta blockers as first-line drugs in the treatment of hypertension. This conclusion is based on the relatively weak effect of beta-blockers to reduce stroke and the absence of an effect on coronary heart disease when compared to placebo or no treatment," says Lead Review Author Charles Shey Wiysonge, who works at the Ministry of Public Health, in Yaoundé, Cameroon.

The beta blocker given to 75% of these participants was atenolol, and more research is needed to determine whether different beta blockers have different effects.

Wiysonge CS et al. Volmink J. Beta-blockers for hypertension. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD002003. DOI: 10.1002/14651858.CD002003.pub2.

Viagra-like drugs can treat erectile dysfunction in men with diabetes
Around half of all men with diabetes have at least one episode during the course of their condition when they fail to maintain an erection sufficient for sexual intercourse. Many different strategies have been used to overcome this, but a Cochrane Review of clinical trials shows that three phosphodiesterase type 5 (PDE-5) inhibitors, sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) increased diabetic men's satisfaction with their sexual life, compared to placebo.