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Query: UMLS:C0085580 (essential hypertension)
 14,686 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effects of metoprolol, a selective beta adrenergic receptor antagonist, on blood pressure, beta receptor blockade (antagoinst of isoproterenol and exercise tachycardia), and plasma renin activity (PRA) have been compared with those of placebo in 16 patients with essential hypertension. The dose of metroprolol was 25 mg three times daily for 1 wk and thereafter 100 mg three times daily for 5 wk. The mean decrease in blood pressure during treatment with metoprolol was 24 +/- 3.8 (SEM)/10 +/- 2.1 mm Hg in the lying position and 23 +/- 4.4/9 +/- 3.1 mm Hg after 1 min in the standing position. At a dose of 2.9 to 5.4 mg/kg, steady-state plasma concentrations of metoprolol varied 17-fold (from 20 to 341 ng/ml) between patients and correlated with the interindividual variability in isoproterenol antagonism (r = 0.58, p less than 0.05) and decrease in exercise tachycardia (r = 0.65, p less than 0.01). By contrast, neither of these variables correlated with the dose of metoprolol in mg/kg. Metoprolol decreased PRA by 67 +/- 1.9 and 71 +/- 1.2% in the lying and standing positions, respectively. The decrease in the mean arterial blood pressure in the lying position was significantly correlated to the PRA during the placebo period (r = 0.61, p less than 0.05) but not to the plasma steady-state levels of metoprolol, the degree of beta receptor blockade, and the decrease in PRA.
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PMID:Plasma levels and effects of metoprolol on blood pressure, adrenergic beta receptor blockade, and plasma renin activity in essential hypertension. 0 73

Metoprolol is a beta1-selective adrenoceptor blocking drug. In hypertension, its duration of effect is longer than expected from its half-life and it is suitable for twice daily administration. There is some evidence that once daily administration may be possible in treating hypertension. It is similar in efficacy to other beta-adrenoceptor blocking drugs in angina pectoris and essential hypertension, when given in equiactive beta-blocking dosages. Metoprolol is well tolerated and side-effects have not proved a problem. It has some pharmacodynamic and pharmacokinetic differences from other beta-adrenoceptor blocking drugs and may prove useful in cases where these differences are shown to be clinically important.
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PMID:Metoprolol: a review of its pharmacological properties and therapeutic efficacy in hypertension and angina pectoris. 20 41

The antihypertensive effect of the selective beta-1-adrenoceptor blocker, metoprolol, administered once daily was evaluated in 32 patients with primary hypertension. After a 4-wk placebo period, the patients were treated with either 150 mg or 300 mg of metoprolol, once daily, for 8 wk. Initially and during the treatment periods blood was drawn for analysis of metoprolol in plasma, plasma renin activity (PRA), and electrolytes, and urine was collected for determination of the urinary aldosterone excretion. Metoprolol reduced the blood pressure measured up to 26 hr after the last dose. The percentage of responders to metoprolol (decrease of mean arterial pressure greater than or equal to 10% over placebo) was 40% for patients on 150 mg and 71% for patients on 300 mg. Except in the standing position, heart rates were reduced for 26 hr after a 150-mg dose. There was a correlation between pretreatment PRA levels and antihypertensive effect of metoprolol in patients on 300 mg metoprolol but not in patients on 150 mg. Urinary aldosterone decreased equally during treatment in responders and nonresponders. Antihypertensive effects and side effects did not correlate with plasma metoprolol concentrations.
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PMID:Once-daily metoprolol in primary hypertension. 37 2

1. A double-blind cross-over evaluation of the anti-hypertensive effect of metoprolol vs placebo was carried out in a series of twenty-three patients with mild or moderate essential hypertension who were receiving 25 mg of chlorthalidone daily as their basic treatment. An individually determined dose of metoprolol (75-300 mg) was used. 2. Metoprolol, as compared with placebo, produced a statistically significant reduction of blood pressure, both in supine and standing positions. 3. During the double-blind cross-over study mild side effects were more common at the beginning of metoprolol/chlorthalidone treatment than during placebo/chlorthalidone, but these tended to diminish or disappear with time. 4. Metoprolol in combination with chlorathalidone appears to be an effective and well-tolerated treatment for mild and moderate hypertension in patients not responding to chlorthalidone alone.
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PMID:A controlled study on the anti-hypertensive effect of a new beta-adrenoreceptor-blocking drug, metoprolol, in combination with chlorthalidone. 79 61

The effect of the new beta-receptor-blocking drug metoprolol on hemodynamics and plasma renin activity was studied at rest and during exercise. 5 patients with essential hypertension were investigated before, 4 weeks after and 8 weeks after oral treatment (3 X 50 mg day). The results were compared to data of 5 patients under propranolol matched according to age, arterial blood pressure, and renin concentration. Metoprolol leads to a significant fall in renin and heart rate, whereas cardiac index is depressed only during exercise. Peripheral resistance remains unchanged and left ventricular filling pressure rises slightly. This results in a slight fall in arterial blood pressure. In comparison with propranolol the hemodynamic and renin patterns under metoprolol are similar, the only difference being the slighter fall in blood pressure due to a less depressed cardiac index.
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PMID:[Hemodynamic changes under metoprolol compared to propranolol in hypertensive patients]. 101 75

Background data revealed that some American and Japanese patients with essential hypertension, including many who were not being treated with any anti-hypertensive drug, had a deficiency of coenzyme Q10. Eight clinically used anti-hypertensive drugs have now been tested for inhibition of two mitochondrial coenzyme Q10-enzymes of heart tissue, succinoxidase and NADH-oxidase. Diazoxide and propranolol significantly inhibited the CoQ10-succinoxidase and CoQ10-NADH-oxidase, respectively. Metoprolol did not inhibit succinoxidase, and was one-fourth as active as propranolol for inhibition of NADH-oxidase. Hydrochlorothiazide, hydralazine, ans clonidine also inhibited CoQ10-NADH-oxidase. Reserpine did not inhibit either CoQ10-enzyme, and methyldopa was a very eak inhibitor of succinoxidase. The internationally recognized clinical side-effects of propranolol may be due, in part, to inhibition of CoQ10-enzymes which are indispensable in the bioenergetics of cardiac function. A pre-existing deficiency of coenzyme Q10 in the myocardium of hypertensive patients could be augmented by subsequent treatment with propranolol, possibly to the "life-threatening" state described by others.
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PMID:Bioenergetics in clinical medicine. III. Inhibition of coenzyme Q10-enzymes by clinically used anti-hypertensive drugs. 119 30

To investigate the effects of antihypertensive drugs on hemodynamic and sympathetic nerve responses to exercise, graded ergometer exercise tests were performed before and after two-week administration of nifedipine, captopril and metoprolol in 18 patients with essential hypertension. The arterial pressure, heart rates (HR), and left ventricular functions as obtained by echocardiography, and the plasma norepinephrine (PNE) levels, were evaluated at rest and during submaximal exercise before and after two-week treatment with nifedipine (40 mg/day, 5 cases), captopril (37.5-75 mg/day, 6 cases) and metoprolol (60 mg/day, 7 cases). These 3 drugs significantly reduced systolic (SBP) and diastolic (DBP) blood pressures but caused no significant changes in resting PNE levels. Nifedipine produced no significant changes in HR and cardiac output (CO) at rest, but augmented the increase in HR (delta HR) and SBP (delta SBP) during submaximal exercise. The increase in PNE (delta PNE) was also augmented by nifedipine. Captopril reduced left ventricular end-diastolic volume and CO without changes in HR and fractional shortening (FS) at rest; whereas, it did not affect delta HR, delta CO, delta SBP or delta PNE during exercise. Metoprolol reduced HR and CO at rest, and also resulted in a decrease in delta FS and delta CO during submaximal exercise. delta SBP was unchanged and delta PNE was increased by treatment with metoprolol. These results indicate that, in hypertensive subjects, the effects on the hemodynamic and sympathetic nerve responses to exercise are different among these 3 antihypertensive drugs despite their identical effects on blood pressure.
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PMID:[Effects of calcium antagonist, angiotensin-converting enzyme inhibitors and beta-blocker on hemodynamic and sympathetic nerve responses to exercise in essential hypertension]. 168 86

Using ultrasound techniques, parameters of left ventricular systolic and diastolic function were assessed in 23 patients with degree I-II essential hypertension treated with metoprolol. Metoprolol administration was followed by increases in ejection fraction (p less than 0.01) and stroke volume (p less than 0.05), a decrease in heart rate (p less than 0.01) while cardiac output remained unchanged. Left ventricular filling was abnormal in 12 patients (52.2%). After metoprolol, the ratio of early diastolic to late diastolic transmitral velocity (E/A) rose; the increase indirectly correlated both with the baseline value of E/A (r = -0.59, p less than 0.01), and the change in heart rate (t = -0.65, p less than 0.01). Improved left ventricular diastolic filling was significant only in patients showing abnormal baseline diastolic function, and may be due to the decrease in heart rate rather than a direct effect exerted by metoprolol on the myocardium.
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PMID:The effect of metoprolol on left ventricular systolic and diastolic function in essential hypertension. 183 84

The cardiovascular responses of 24 healthy young adult males with a parental history of hypertension and 24 males without a parental history of hypertension to an extended active-coping psychological stressor were compared under three drug conditions: placebo, the beta 1-blocking agent metoprolol, and the alpha 1-blocking agent prazosin. In the placebo condition, offspring of hypertensives exhibited significantly greater heart rate, blood volume pulse, and forearm blood flow responses to the task. They also exhibited a significantly greater initial decrease in forearm vascular resistance, which, in contrast to the offspring of normotensives, was no longer significantly different from baseline levels by the end of the session. No group differences in blood pressure response were observed. Metoprolol eliminated the differences in heart rate and forearm vascular resistance responses. Prazosin eliminated the difference in blood volume pulse response and elicited a sustained group difference in forearm vascular resistance. These results implicate the sympathetic nervous system in the exaggerated cardiovascular responsivity to psychological stress in individuals with a family history of essential hypertension. They also suggest that the pattern of increasing vascular resistance in response to this stressor observed in this and other studies in this laboratory reflects alpha-adrenergic activity and not neurohumorally independent autoregulation.
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PMID:Exaggerated sympathetic nervous system response to extended psychological stress in offspring of hypertensives. 188 58

The authors tested in an open, uncontrolled trial in a group of 23 patients with essential hypertension grade I-II (WHO classification) the effect of Metoprolol OROS. The OROS system is a new form of Metoprolol administration which makes it possible to maintain by a single dose per day a steady plasma concentration, while preserving the cardioselectivity and total 24-hour effectiveness during treatment of hypertension and angina pectoris. After eight weeks of Metoprolol OROS administration, in doses gradually adjusted to the therapeutic action, gradually a significant decrease of the heart rate (HR) occurred, of the systolic blood pressure (BPs) and diastolic blood pressure (BPd) (p less than 0.01 for all values) in a recumbent as well as upright position. A reduction of the BPd in an upright position by greater than or equal to 10 mm Hg was achieved in 85% of the patients, in 73.9% of the patients the BPd in an upright position dropped below 95 mm Hg. Four patients developed side-effects which were mild to medium severe (vertigo, palpitations, fatigue, sensation of tremor, tension in the lower extremities). Two patients discontinued treatment early, the main reason in both being palpitations which were under better conversely, in two patients palpitations which were not adequately controlled by previous metoprolol treatment, disappeared completely during Metoprolol OROS treatment. During the trial no significant changes in the investigated laboratory values incl. total cholesterol were recorded, Metoprolol OROS administered once per day is an effective, safe and well tolerated preparation in treatment of mild to medium severe essential hypertension.
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PMID:[The effect of OROS metoprolol in mild and moderately severe essential hypertension]. 239 74


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