Perspective:

Although limited by a retrospective study design and the potential impact of unmeasured confounding in administrative data, the current study offers insight into the comparative effectiveness of atenolol and metoprolol tartrate for primary prevention. While recent literature has implicated the limitations of beta-blocker therapy for the management of uncomplicated hypertension, most evidence comes from the use of atenolol and the question of whether trial outcomes are simply related to this particular drug (versus a class effect) has largely been unanswered. Although this study may indicate that the unfavorable trial data associated with atenolol may apply to metoprolol tartrate, the fact remains that no primary prevention trial has compared atenolol head-to-head with other beta-blockers.