For decades doctors have prescribed beta blockers as a first-line treatment for high blood pressure. Now, a new study published online by the journal Lancet suggests that many  patients might be better off with a different medication. The Swedish study reviewed results of 13 randomized trials that involved more than 105,000 subjects and compared beta blockers with other blood-pressure drugs, such as ACE inhibitors, calcium channel blockers and diuretics. Beta blockers were no more effective than other medications at preventing heart attacks, and were associated with a 16% higher risk of stroke and 3% greater risk of death from any cause. Patients taking the beta blocker atenolol, in particular, had a 26% higher risk of stroke than patients prescribed other antihypertensives. Still, beta blockers are better than nothing—compared with a placebo, the study found that these drugs reduced stroke risk by 19%. The authors say, however, that's about half the reduction found in previous studies of beta blockers and other blood-pressure-lowering drugs.

While the study recommends that doctors replace beta blockers with other medications as first-line antihypertensives, a separate accompanying editorial says that certain patients—those who already have heart disease, for example—may still need beta blockers and should continue taking them. Other patients, like those with migraine headaches can also benefit. Stopping treatment suddenly could lead to rebound chest pain, high blood pressure or a heart attack, so check with your doctor before switching medications, and make sure you make any changes gradually.