title: [Antihypertensive first-line and add-on treatment with a fixed controlled release combination of metoprololsuccinate/hydrochlorothiazide. Prospective doctor's office observational study in 14,964 patients].
abstract: OBJECTIVE
  To evaluate the efficacy and tolerability of a single daily dose of a fixed combination of 95 mg metoprololsuccinate (MS) and 12.5 mg hydrochlorothiazide (HCTZ) in the first-line treatment of non-pretreated hypertensives, or additional (add-on) to ongoing antihypertensive medication.
  
  
  METHODS
  14,964 patients aged 18 years or older treated by 2808 family doctors in Germany were included in a noncontrolled observational study. Most patients had at least one concurrent disease or concomitant medication of one kind or another. The primary target parameters for efficacy was the lowering of the systolic blood pressure (SBP) and diastolic blood pressure (DBP) after 8 weeks and for tolerability the number of patients reporting adverse events (AE).
  
  
  RESULTS
  65.4% of the patients received MS/HCTZ in the form of first-line treatment, the remainder as add-on therapy. The mean blood pressure decrease for the overall group by the end of the study was -24.5/-13.6 mmHg (baseline: 166.7/97.3 mmHg; p < 0.0001 for SBP and DBP). 92.2% of the patients experienced a decrease in SBP of > or = 10 mmHg. The mean heart rate decreased by 10.2 beats (baseline 81.4; p < 0.0001). The blood pressure decreased both in patients receiving MS/HCTZ alone and in those receiving it as an add-on to other antihypertensives. Only 1.4 of the patients reported AE.
  
  
  CONCLUSIONS
  The MS/HCTZ controlled release combination was safe, efficacious and well-tolerated both as first-line and add-on therapy for essential hypertension.
authors.affiliation: Klinische Forschung, Pharmacia GmbH, Erlangen.
authors.forename: S K
authors.initials: SK
authors.lastname: Hildemann
authors.forename: H M
authors.initials: HM
authors.lastname: Fischer
authors.forename: D
authors.initials: D
authors.lastname: Pittrow
authors.forename: V
authors.initials: V
authors.lastname: Bohlscheid
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D003692:Delayed-Action Preparations; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage* / Q000009:adverse effects; D006973:Hypertension / Q000188:drug therapy*; D007388:Internal Medicine; D008297:Male; D008790:Metoprolol / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives*; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D000959:Antihypertensive Agents; D003692:Delayed-Action Preparations; D004338:Drug Combinations; D006852:Hydrochlorothiazide; D008790:Metoprolol