What do systematic reviews say?

First‐line beta‐blocker vs placebo

First‐line beta‐blocker may leads to lower total cardiovascular events compared with placebo (low certainty).

• First‐line drugs for hypertension 2018 · Cochrane Headline outcomes only
  RR 0.89 [0.81, 0.98]
  5 studies · 19313 participants
  Low

First‐line thiazides vs beta‐blocker

• First‐line diuretics versus other classes of antihypertensive drugs for hypertension 2023 · Cochrane Headline outcomes only
  no estimate extracted
  4 studies · 18135 participants
  Moderate

RAS inhibitors vs beta‐blocker

RAS inhibitors may leads to lower total cardiovascular events compared with beta‐blockers (low certainty).

• First‐line drugs inhibiting the renin angiotensin system versus other first‐line antihypertensive drug classes for… 2018 · Cochrane Headline outcomes only
  RR 0.88 [0.8, 0.98]
  2 studies · 9239 participants
  Low