What do systematic reviews say?

First‐line beta‐blocker vs placebo

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

• First‐line drugs for hypertension 2018 · Cochrane Headline outcomes only
  RR 0.83 [0.72, 0.97]
  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
  Low

RAS inhibitors vs beta‐blocker

RAS inhibitors may leads to lower total stroke 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 0.75 [0.63, 0.88]
  1 study · 9193 participants
  Low