Hypertension

Heart rate-lowering drugs and outcomes in hypertension and/or cardiovascular disease: a meta-analysis

Eur Heart JPublished Systematic review and meta-analysis of randomised trials

Authors' conclusion

The HR reduction benefits are context-dependent.

Study context

Population
Patients with hypertension and/or CVD
Participants
157,764 patients74 trials
Comparison
HR-lowering drugs vs placebo or less intensive treatment
Outcome
CV outcomes, mortality and adverse events
Follow-up
2.7 years
Methodological detailsrandom-effects model
  • Random-effects model

Pooled result

As reported in the abstract

Average HR reduction (b.p.m.)
8.2
Baseline/attained HR (b.p.m.)
76.2/65.6
CHD reduced by
16%
HF reduced by
9%
Cardiovascular (CV) mortality reduced by
14%
All-cause mortality reduced by
13%

Further pooled results

Mortality, post-acute MI and HF (subgroups)

Significant mortality reductions

Outcomes, hypertension without CVD (subgroup)

No significant outcome changes
Entire hypertensive population: increased stroke and mortality

Outcomes by HR threshold (≥80 to almost 70 b.p.m.)

Effect not different across cutoffs, except for HF

Outcomes by attained HR target (≥70 to <65 b.p.m.)

Not different across progressively lower targets, except permanent discontinuations (incremental trend)

Safety

Adverse event-driven discontinuations

Increased by
25%

Original publication

Heart rate-lowering drugs and outcomes in hypertension and/or cardiovascular disease: a meta-analysis. Eur Heart J. Published 25 April 2025. doi:10.1093/eurheartj/ehaf291

Composed by AI from the published abstract and checked against it. How Briefs are made →

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