Meskipun ''beta blocker'' menurunkan tekanan darah, mereka tidak memiliki manfaat positif pada titik akhir seperti yang dilakukan beberapa antihipertensi lainnya.[35]<ref name="betablockers">{{cite journal | vauthors = Lindholm LH, Carlberg B, Samuelsson O | title = Should beta blockers remain first choice in the treatment of primary hypertension? A meta-analysis | journal = Lancet | volume = 366 | issue = 9496 | pages = 1545–53 | date = 29 Oct – 4 Nov 2005 | pmid = 16257341 | doi = 10.1016/S0140-6736(05)67573-3 | s2cid = 34364430 }}</ref> Secara khusus, ''beta- blocker'' tidak lagi direkomendasikan sebagai pengobatan lini pertama karena risiko stroke[[strok]] yang relatif buruk dan timbulnya [[diabetes melitus tipe 2]] yang baru jika dibandingkan dengan obat lain,[3]<ref name=nps02 /> sementara ''beta- blocker'' tertentu seperti atenolol tampaknya kurang berguna dalam pengobatan hipertensi secara keseluruhan daripada beberapa agen lainnya.[36]<ref name="atenolol">{{cite journal | vauthors = Carlberg B, Samuelsson O, Lindholm LH | title = Atenolol in hypertension: is it a wise choice? | journal = Lancet | volume = 364 | issue = 9446 | pages = 1684–9 | date = 6–12 Nov 2004 | pmid = 15530629 | doi = 10.1016/S0140-6736(04)17355-8 | s2cid = 23759357 }}</ref> Tinjauan sistematis dari 63 uji coba dengan lebih dari 35.000 peserta menunjukkan ''β-blocker'' meningkatkan risiko mortalitas, dibandingkan dengan terapi antihipertensi lainnya.[15]<ref name=wu>{{cite journal | vauthors = Wu HY, Huang JW, Lin HJ, Liao WC, Peng YS, Hung KY, Wu KD, Tu YK, Chien KL | title = Comparative effectiveness of renin-angiotensin system blockers and other antihypertensive drugs in patients with diabetes: systematic review and bayesian network meta-analysis | journal = BMJ | volume = 347 | pages = f6008 | date = October 2013 | pmid = 24157497 | pmc = 3807847 | doi = 10.1136/bmj.f6008 }}</ref> Namun, mereka memiliki peran penting dalam pencegahan serangan jantung pada orang yang pernah mengalami serangan jantung.[37]<ref name="bbmi">{{cite journal | vauthors = Freemantle N, Cleland J, Young P, Mason J, Harrison J | title = beta Blockade after myocardial infarction: systematic review and meta regression analysis | journal = BMJ | volume = 318 | issue = 7200 | pages = 1730–7 | date = June 1999 | pmid = 10381708 | pmc = 31101 | doi = 10.1136/bmj.318.7200.1730 }}</ref> Di Inggris[[Britania Raya]], pedoman "Hipertensi: Penatalaksanaan Hipertensi pada Orang Dewasa dalam Perawatan Primer"<ref>{{cite web|title=Hypertension: management of hypertension in adults in primary care |url=http://www.nice.org.uk/download.aspx?o=CG034quickrefguide |format=PDF |publisher=[38[National Institute for Health and Clinical Excellence]] |access-date=2006-09-30 |url-status=dead |archive-url=https://web.archive.org/web/20070216204848/http://www.nice.org.uk/download.aspx?o=CG034quickrefguide |archive-date=2007-02-16 }}</ref> Juni 2006 dari Institut Nasional untuk Kesehatan dan Keunggulan Klinis, menurunkan peran ''beta- blocker'' karena risiko memicu diabetes melitus tipe 2.<ref>{{cite web | vauthors = Ladva S | title=NICE and BHS launch updated hypertension guideline | url=http://www.nelm.nhs.uk/Record%20Viewing/viewRecord.aspx?id=567178 | archive-url=https://web.archive.org/web/20070929210400/http://www.nelm.nhs.uk/Record%20Viewing/viewRecord.aspx?id=567178 | url-status=dead | archive-date=2007-09-29 | date=2006-06-28 | publisher=[39[National Institute for Health and Clinical Excellence]] | access-date=2006-09-30 }}</ref>
Meskipun menurunkan tekanan darah, ''alpha blocker'' memiliki hasil akhir yang jauh lebih buruk daripada antihipertensi lainnya, dan tidak lagi direkomendasikan sebagai pilihan lini pertama dalam pengobatan hipertensi.<ref name="alpha">{{cite journal | author = ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group | title = Diuretic versus alpha-blocker as first-step antihypertensive therapy: final results from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) | journal = Hypertension | volume = 42 | issue = 3 | pages = 239–46 | date = September 2003 | pmid = 12925554 | doi = 10.1161/01.HYP.0000086521.95630.5A | doi-access = free }}</ref> Namun, obat ini mungkin berguna bagi sebagian pria dengan gejala penyakit prostat.
