Key result
Toprol-XL plus HCTZ effectively lowers blood pressure across multiple doses with ~3% adverse event discontinuation.
Why the study?
Most hypertensive patients require two or more drugs to achieve target blood pressure, and diuretic-based regimens have proven effective in reducing cardiovascular morbidity and mortality.
Does the combination of metoprolol succinate extended release and hydrochlorothiazide effectively reduce blood pressure in patients with essential hypertension?
RCT (n=1,571)
Double-blind
unbalanced factorial
Yes
Does the combination of metoprolol succinate extended release and hydrochlorothiazide effectively reduce blood pressure in patients with essential hypertension?
The combination of metoprolol succinate extended release and hydrochlorothiazide is an effective and well-tolerated antihypertensive regimen across a wide range of doses.
Supports metoprolol succinate ER plus hydrochlorothiazide for essential hypertension; extends RCT evidence for beta-blocker/diuretic combinations across doses.
Most hypertensive patients require 2 or more drugs to achieve target blood pressure. Results of the ALLHAT trial indicate that diuretic-based antihypertensive regimens are effective in reducing cardiovascular morbidity and mortality. The ATTACH trial evaluated 3 dose levels of hydrochlorothiazide (HCT) (6.25 mg, 12.5 mg and 25 mg), 4 levels of metoprolol succinate extended release (Toprol-XL) (25 mg, 50 mg, 100 mg and 200 mg), 9 of the possible combinations and placebo in an 8 week, multicenter, randomized, double-blind unbalanced factorial trial in patients with essential hypertension (DBP > 95, ≤ 114 mm Hg; SBP<180 mm Hg). The investigators randomized 1571 patients; 51% were male, 16% were > 65 years of age and 25% were black. Mean baseline blood pressure was 151/100 mm Hg. Forty-six (2.9%) patients discontinued for adverse events but there was no clustering of events in any one treatment group. Serum potassium declined with HCT and was related to dose. Toprol-XL-HCT is an effective antihypertensive combination agent over the range of doses (HCT 6.25 mg to 25 mg; Toprol-XL 25 mg to 200 mg).
No takes yet. Share an insight, caveat, or question.
Papademetriou et al. (2005) conducted an RCT in essential hypertension (n=1,571). Toprol-XL and hydrochlorothiazide combination vs. Placebo was evaluated. Toprol-XL combined with hydrochlorothiazide was an effective antihypertensive agent across multiple dose ranges, with 2.9% of patients discontinuing due to adverse events.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: