[Response to metoprolol succinate sustained-release tablets in correlation to pulse pressure, serum vascular endothelial growth factor and C-reactive protein in elderly hypertensive patients with chronic heart failure].
OBJECTIVE
To investigate the effect of metoprolol succinate sustained-release tablets on cardiac function, serum vascular endothelial growth factor (VEGF) and C-reactive protein (CRP) in elderly hypertensive patients and its relation with pulse pressure (PP).


METHODS
A total of 330 elderly hypertensive patients with chronic heart failure receiving basic therapy were included. Before initiation and 3 months after the maximal tolerated dose of metoprolol succinate sustained-release tablets, the parameters of blood pressure, clinical features, radionuclide ventriculographic and laboratory findings of the patients were analyzed.


RESULTS
As the PP was elevated, the serum levels of VEGF, hs-CRP and BNP increased and the cardiac systolic and diastolic functions decreased. In patients with PP of 59-68 mmHg and > 68 mmHg, 3 months of treatment with the tablets caused significantly increased LVEF by (3.32 ± 2.35)% and (4.12 ± 3.05)% and LVPER by 0.37 ± 0.26 and 0.53 ± 0.37, respectively; PP were decreased by 8.2 ± 3.1 mmHg and 9.4 ± 4.3 mmHg and VEGF by 18.39 ± 8.43 pg/ml and 26.79 ± 14.32 pg/ml, respectively. The treatment also resulted in lowered hs-CRP and BNP in these patients by 0.26 ± 0.13 mg/L and 0.33 ± 0.16 mg/L and by 140.36 ± 68.62 ng/L and 155.39 ± 73.58 ng/L, respectively.


CONCLUSIONS
Obvious elevation of PP is associated with a better response to metoprolol succinate sustained-release tablets in elderly hypertensive patients with chronic heart failure, and 3 months of treatment with the tablets can significantly improve the cardiac function and lower the levels of VEGF, hs-CRP and BNP in these patients.
Zhang
Zhi-wei
ZW
Department of Cardiology, Sun Yat-sen Cardiovascular Hospital, Shenzhen 518020, China. xiaosi1210000@ 163.com
Lin
Ze-peng
ZP
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism*; D002908:Chronic Disease; D003692:Delayed-Action Preparations; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008790:Metoprolol / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
D000319:Adrenergic beta-Antagonists; D003692:Delayed-Action Preparations; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein; D008790:Metoprolol