TY - JOUR
T1 - Antihypertensive Treatment With Metoprolol or Hydrochlorothiazide in Patients Aged 60 to 75 Years
T2 - Report From a Double-blind International Multicenter Study
AU - Wikstrand, John
AU - Westergren, Gudrun
AU - Berglund, Göran
AU - Bracchetti, Daniele
AU - Van Couter, Antoon
AU - Feldstein, Carlos A.
AU - Ming, Kong Siu
AU - Kuramoto, Kizuku
AU - Landahl, Sten
AU - Meaney, Eduardo
AU - Pedersen, Erling B.
AU - Rahn, Karl H.
AU - Shaw, John
AU - Smith, Anthony
AU - Waal-Manning, Hendrika
PY - 1986/3/14
Y1 - 1986/3/14
N2 - In a randomized double-blind study (N=562), a traditional treatment schedule, starting antihypertensive treatment in elderly hypertensive patients (60 to 75 years old) with 25 mg of hydrochlorothiazide once daily and doubling the dose if a satisfactory response was not achieved, was compared with antihypertensive treatment of 100 mg of metoprolol once daily, adding 12.5 mg of hydrochlorothiazide for patients whose response was not satisfactorialy achieved with metoprolol alone. Systolic and diastolic blood pressure was significantly reduced with both regimens. The frequency rates of responders (diastolic blood pressure, ≤95 mm Hg) in the metoprolol group and the hydrochlorothiazide group were 50% and 47% after four weeks and 65% and 61% after eight weeks, respectively. There were no significant differences in total symptom score or single symptoms between the regimens, but significantly more patients had hypokalemia and hyperuricemia with the hydrochlorothiazide regimen. Thus, we conclude that beginning antihypertensive treatment with 100 mg of metoprolol once daily and adding a small dose of hydrochlorothiazide (12.5 mg) in patients whose response is not satisfactory with metoprolol alone appears to be effective and safe in elderly hypertensive patients.
AB - In a randomized double-blind study (N=562), a traditional treatment schedule, starting antihypertensive treatment in elderly hypertensive patients (60 to 75 years old) with 25 mg of hydrochlorothiazide once daily and doubling the dose if a satisfactory response was not achieved, was compared with antihypertensive treatment of 100 mg of metoprolol once daily, adding 12.5 mg of hydrochlorothiazide for patients whose response was not satisfactorialy achieved with metoprolol alone. Systolic and diastolic blood pressure was significantly reduced with both regimens. The frequency rates of responders (diastolic blood pressure, ≤95 mm Hg) in the metoprolol group and the hydrochlorothiazide group were 50% and 47% after four weeks and 65% and 61% after eight weeks, respectively. There were no significant differences in total symptom score or single symptoms between the regimens, but significantly more patients had hypokalemia and hyperuricemia with the hydrochlorothiazide regimen. Thus, we conclude that beginning antihypertensive treatment with 100 mg of metoprolol once daily and adding a small dose of hydrochlorothiazide (12.5 mg) in patients whose response is not satisfactory with metoprolol alone appears to be effective and safe in elderly hypertensive patients.
UR - http://www.scopus.com/inward/record.url?scp=84944282009&partnerID=8YFLogxK
U2 - 10.1001/jama.1986.03370100098025
DO - 10.1001/jama.1986.03370100098025
M3 - Artículo
SN - 0098-7484
VL - 255
SP - 1304
EP - 1310
JO - Journal of the American Medical Association
JF - Journal of the American Medical Association
IS - 10
ER -