Abstract

The hypotensive effect of metoprolol at doses from 60 to 120 mg/day was studied in 10 patients with mild to moderate essential hypertension (4 males and 6 females, the average 55.6±9.7 years old). The effects of metoprolol on hemodynamics (9 cases) and plasma renin activity (7 cases) were simultaneously studied in these patients. The hypotensive effect of metoprolol was rapid, and was more marked in diastolic than in systolic. Metoprolol decreased the diastolic blood pressure significantly from 103.7±8.8 mmHg (Mean±S. D.) in supine position before administration to 97.6±8.8 mmHg in the second week. The hypotensive effect continued for some time afterwards, and even in the 10 th week the diastolic blood pressure recorded 92.0±11.1 mmHg.Metoprolol caused significant decrease in the pulse rate. Dose of metoprolol was increased in 3 cases, in one of which the hypotensive effect tended to increase further. In 2 cases with chronic obstructive airway disease, the administration of metoprolol did not aggravate the symptoms. In 3 out of 9 cases, metoprolol induced marked decrease in cardiac output, but did not cause any reduction in blood pressure. In 2 cases, a remarkable reduction in total peripheral resistance was observed after the administration of metoprolol, and in these cases the hypotensive effect was remarkable.There is a significant positive correlation between the, change in the diastolic blood pressure and that in the total peripheral resistance. Metoprolol gave variable influence on the change in plasma renin activity, and there was no correlation between the change in plasma renin activity and that in the blood pressure. Metoprolol could be used safely and effectively for the patients with essential hypertension including those with chronic obstructive airway disease. Its hypotensive effect is thought to mainly be due to the decrease in peripheral vascular resistance.

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