First-Line β-Blocker Use for Hypertension in the Veterans Health Administration

What is the prevalence of and what are the factors associated with first-line β-blocker use for hypertension among those without compelling indications for a β-blocker?In this cross-sectional study of 774 821 veterans initiating a β-blocker for hypertension between 2000 and 2022, the proportion without a compelling indication was high (88% overall) but decreased over time (92% to 82%). Among those without compelling indications, β-blocker initiation varied by sociodemographic and clinical factors, including age, sex, race and ethnicity, and history of comorbid conditions.These findings suggest that despite national guidelines discouraging first-line β blocker use among those without compelling indications since 2014, this practice is still common, and interventions are needed to improve guideline-concordant initial treatment for hypertension.

Corresponding Author: Catherine G. Derington, PharmD, MS, University of Colorado School of Medicine, 12631 E 17th Ave, Mail Stop B-130, Aurora, CO 80045 (catherine.derington@cuanschutz.edu).

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