To the Editor Meta-analyses of β-blocker efficacy in reducing all-cause death and cardiovascular events in patients with hypertension that do not take age into account are liable to miss the essential strengths and weaknesses of β-blockade.1
The Framingham Heart Study2 has shown that the development of diastolic hypertension occurs in younger patients and is closely linked to obesity, in contrast to isolated systolic hypertension that occurs in older patients and is associated with aging and stiffening of the arteries. Appropriate treatment for these 2 types of hypertension will require different approaches, particularly because central obesity is linked to high levels of sympathetic nerve activity in younger individuals.3
Cruickshank J. β-Blocker Therapy for Patients With Hypertension. JAMA. 2014;311(8):862. doi:10.1001/jama.2014.321
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