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Invited Commentary
Oct 8, 2012

Observational Comparative Effectiveness Studies of Drug TherapiesHigh-Quality Answers or Important Clinical Questions?
Comment on “Comparative Effectiveness of 2 β-Blockers in Hypertensive Patients”

Author Affiliations

Author Affiliations: Cardiovascular Health Research Unit (Drs Floyd and Psaty) and Departments of Medicine (Drs Floyd and Psaty), Epidemiology (Dr Psaty), and Health Services (Dr Psaty), University of Washington, Seattle; and Group Health Research Institute, Group Health Cooperative, Seattle (Dr Psaty).

Arch Intern Med. 2012;172(18):1412-1414. doi:10.1001/archinternmed.2012.4306

For the prevention of cardiovascular disease (CVD), β-blockers are among the most widely used therapies. Multiple clinical trials have established their efficacy in preventing death after myocardial infarction (MI) and in treating congestive heart failure (CHF) due to systolic dysfunction.1,2 β-Blockers have also long been used to treat hypertension. Although low-dose diuretics are the recommended first-line agent for pharmacologic therapy for uncomplicated high blood pressure,3 several large trials funded by the pharmaceutical industry have used β-blockers as the active-comparison control treatment,4 and the results of these trials suggest that other therapies are more effective than atenolol in preventing cardiovascular events, particularly stroke.5,6 Because no primary prevention trial among hypertensive patients has compared atenolol head to head with other β-blockers, their comparative effectiveness in this setting remains unknown.

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