Clinical evaluation of the antihypertensive effect of metoprolol in combination with hydrochlorothiazide and hydralazine in an unselected hypertensive population.

One hundred nineteen patients with essential hypertension (96 completing six months and 92 a one year study period) were randomized into four parallel groups and treated with one of four programs: 200 mg of metoprolol plus placebo; 200 mg of metoprolol plus 25 mg of hydrochlorothiazide; 200 mg of metoprolol plus 50 mg hydrochlorothiazide, or; 200 mg metoprolol plus 50 mg of hydralazine. Blood pressure reduction was significant in these all groups and no differences were observed in blood pressure reduction among the groups. During the one year therapy the levels of serum bilirubin, uric acid and triglycerides were significantly increased in all groups but the group treated with metoprolol and hydralazine. Serum cholesterol level did not increase in any group during the one year therapy. The results indicate that the combination therapy in mild to moderate hypertension should not be initiated before individual response to single drug therapy is evaluated. Antihypertensive drug treatment may cause some biochemical changes and those changes seem to be smallest patients treated with combination of beta-blocker and hydralazine.