Metoprolol in hypertension: an open evaluation.

We studied the efficacy and tolerability of metoprolol, administered alone or in combination therapy, in 703 hypertensive patients. We observed a significant decrease in both systolic and diastolic blood pressure in patients treated with metoprolol alone or with metoprolol and a diuretic. Of these, 60% to 85% achieved a diastolic blood pressure of 12 kPa (90 mmHg) or lower during the 12-week trial. The maximum effect occurred after approximately three weeks. In the majority of patients, 100 mg twice a day controlled mild to moderate hypertension. Side effects (mainly gastrointestinal disturbances and dizziness) occurred in 15% of patients receiving metoprolol alone and led to treatment withdrawal in 6.7%. For the total patients population, these frequencies were 13.5% and 6.7% respectively, and decreased with time. Asthmatics and diabetics tolerated metoprolol extremely well, indicating the clinical importance of metoprolol's cardioselectivity.