A systematic review including 90 RCTs was abstracted in DARE. Rates of cardiac death and myocardial infarction were not significantly different for treatment with beta-blockers versus calcium antagonists (OR 0.97, 95% CI 0.67 to 1.38). There were 0.31 (95% CI 0.00 to 0.62) fewer episodes of angina per week with beta-blockers than with calcium antagonists, and beta-blockers were discontinued less often because of adverse effects (OR 0.72, 95% CI 0.60 to 0.86). The rate of adverse events was highest for nifedipine. There were no differences in time to ischaemia in the exercise test between calcium antagonists and beta-blockers. Too few trials compared nitrates with beta-blockers or calcium antagonists to draw firm conclusions.
Comment: The quality of evidence is downgraded by limitations in review methodology.