Reduction of nonfatal reinfarctions in patients with a history of hypertension by chronic postinfarction treatment with metoprolol.
The Stockholm Metoprolol Trial is a prospective double-blind placebo-controlled postmyocardial infarction study of 301 patients treated with metoprolol, 100 mg b.i.d., or matching placebo for three years. From this study we have retrospectively evaluated the outcome in patients with a history of treatment for hypertension prior to the index infarction. There were 41 such patients in the placebo group and 35 in the metoprolol group. Blood pressures during follow-up were nearly identical in the two groups. During the three years 11 patients died in the placebo group and 7 in the metoprolol group. Corresponding figures for nonfatal events such as reinfarction, coronary artery bypass surgery, cerebrovascular events and lower limb amputation were 12 vs. 1 (p less than 0.005), 3 vs. 0, 4 vs. 0 and 1 vs. 0, respectively. The numbers of patients with fatal and nonfatal events were 24 vs. 8 (p less than 0.01). In a retrospective subgroup analysis the results must always be interpreted with caution. The present results may, however, imply that postinfarction treatment with metoprolol reduces nonfatal atherosclerotic complications, especially nonfatal reinfarctions, in patients with a history of hypertension.
D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality / Q000517:prevention & control; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012189:Retrospective Studies; D012306:Risk
D008790:Metoprolol