Safety and efficacy of metoprolol in the treatment of hypertension in the elderly.
OBJECTIVE
To assess the short-term efficacy and safety of metoprolol in the treatment of hypertension in a large population of older patients.


METHODS
Prospective, open-label surveillance study.


METHODS
Multicenter outpatient offices.


METHODS
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.


METHODS
Patients were treated with 100 mg of metoprolol once daily for 4 week. 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.


METHODS
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 less than 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.
LaPalio
L
L
Loyola University, Stritch School of Medicine, Maywood, Illinois 60153.
Schork
A
A
Glasser
S
S
Tifft
C
C
D000367:Age Factors; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002985:Clinical Protocols / Q000592:standards; D003971:Diastole; D004359:Drug Therapy, Combination; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008790:Metoprolol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D010821:Physicians, Family; D011446:Prospective Studies; D013599:Systole
D006852:Hydrochlorothiazide; D008790:Metoprolol