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Safety And Efficacy of Metoprolol in the Treatment of Hypertension in the Elderly
Author(s) -
LaPalio Lawrence,
Schork Anthony,
Glasser Stephen,
Tifft Charles
Publication year - 1992
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1992.tb02134.x
Subject(s) - medicine , blood pressure , metoprolol , contraindication , hydrochlorothiazide , tolerability , population , diuretic , cardiology , surgery , adverse effect , alternative medicine , environmental health , pathology
Objective To assess the short‐term efficacy and safety of metoprolol in the treatment of hypertension in a large population of older patients. Design Prospective, open‐label surveillance study. Setting Multicenter outpatient offices. Participants 21,692 patients with mild‐to‐moderate hypertension between the ages of 50 to 75 years. Patients were excluded if they had a contraindication to beta‐blocker therapy. Intervention Patients were treated with 100 mg of metoprolol once daily for 4 weeks. If the blood pressure was controlled, therapy was continued for an additional 4 weeks. If adequate blood pressure was not achieved after 4 weeks, 25 mg of hydrochlorothiazide was added. At the end of 8 weeks, final therapy decisions were recorded. If the blood pressure was controlled, therapy was continued for an additional 4 weeks. Main Outcome Measures Blood pressure, heart rate and side‐effects. Results After 4 weeks of therapy, mean systolic and diastolic blood pressures decreased significantly from 162/95 to 148/87 mm Hg ( P < 0.001). Fifty‐eight percent of the patients had satisfactory blood pressure control. At the end of 8 weeks, mean systolic and diastolic blood pressure decreased to 143/84 mm Hg. Blood pressure response was similar in all age groups. At the termination of the study, 50% of the patients were continued on monotherapy, and 27% were continued on combined therapy. Overall, there was less than a 5% incidence of medical problems, and excellent or good tolerability was noted for 94% of the patients. Conclusions Metoprolol administered as monotherapy or in combination with hydrochlorothiazide was effective in normalizing blood pressure in a majority of elderly hypertensive patients. Both drug regimens were well tolerated.