EFFICACY AND SAFETY OF CONTROLLED RELEASE METOPROLOL TARTRATE IN PATIENTS WITH ARTERIAL HYPERTENSION: ERA STUDY RESULTS
https://doi.org/10.20996/1819-6446-2010-6-2-160-165
Abstract
Aim. To evaluate efficacy, safety and influence on quality of life of controlled release metoprolol tartrate (CRMT) in patients with arterial hypertension of 1-3 degree.
Material and methods. 603 patients (256 men and 347 women; 60,1 y.o., in average) with hypertension of 1-3 degree were examined. 67 hypertensive patients had diabetes mellitus (DM). Study duration was 2 months. All patients started monotherapy by CRMT 50-100 mg OD. After 15 days of CRMT therapy daily dose could be increase to 100-150 mg, if the target blood pressure (BP) levels were not reached. After 1 month of treatment if necessary CRMT daily dose could be increased again up to 150-200 mg or another antihypertensive drug could be added. The forth visit after 2 month of therapy was last one. Antihypertensive efficacy, safety and quality of life (by visual analogue scale) were assessed at every visit. Besides the main blood biochemical parameters and electrocardiograms were analyzed for the safety control.
Results. 591 patients completed the study, 12 patients dropped out the study (because of side effects or low treatment compliance). After 2 months of therapy systolic and diastоlic BP was reduced by 36 and 17 mmHg respectively (р<0,001 for both), and target BP levels was achieved in 72,9% and in 78,2% of patients respectively (р<0,01 for both). Target systolic BP (<130 mmHg) and diastolic BP (<80 mmHg) levels were achieved in 27,3% and 28,8% of hypertensive patients with DM, respectively (р<0,01 for both).Side effects were observed in 3,2% of patients. 87% of patients considered therapy tolerability as a good one. CRMT therapy resulted in quality of life rise from 55,7 to 75,4 points (р<0,001) by the end of therapy.
Conclusion. Study results show high efficacy and safety of CRMT in the therapy of hypertensive patients including hypertensive patients with DM.
About the Authors
O. L. Barbarash
Kemerovo State Medical Academy
Russian Federation
Voroshilova ul. 22A, Kemerovo, 650023
Russian Federation
Voroshilova ul. 22A, Kemerovo, 650023
M. V. Zykov
Research Institute for Complex Problems of Cardiovascular Diseases
Russian Federation
Sosnovy bulv. 6, Kemerovo, 650000
Russian Federation
Sosnovy bulv. 6, Kemerovo, 650000
References
1. Маколкин В.И. О целесообразности применения β-адреноблокаторов при артериальной гипертонии: еще раз «за» и «против». Рациональная Фармакотерапия в Кардиологии 2009;5(2):83-8.
2. Lawes C.M., Vander Hoorn S., Rodgers A.; International Society of Hypertension. Global burden of blood-pressure-related disease, 2001. Lancet 2008; 371(9623):1513-8.
3. Диагностика и лечение артериальной гипертензии. Рекомендации Российского медицинского общества по артериальной гипертонии и Всероссийского научного общества кардиологов. Кардиоваскулярная терапия и профилактика2008;7(приложение2):3- 32.
4. Mancia G., De Backer G., Dominiczak A. et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and ofthe European Society of Cardiology (ESC). EurHeart J 2007;28(12):1462-536.
5. Bouhanick B., Chamontin B. Should pulse pressure and day/night variations in blood pressure be seen as independent risk factors requiring correction or simply as markers to be taken into account when evaluating overall vascular risk? Diabetes Metab 2007;33(5):321-30.
6. UK National Institute for Health and Clinical Excellence and British Hypertension Society.Hypertension: managementin adults in primary care: pharmacological update; 2006. Available on http://www.nice.org.uk/ nicemedia/live/10986/30111/30111.pdf
7. Bangalore S.,WildD., Parkar S. et al. Beta-blockers for primary prevention of heartfailure in patients with hypertension: inside from a meta-analysis. J Am Coll Cardiol 2008;52(13):1062-72.
8. Wiysonge C.S., Bradley H., Mayosi B.M. et al. Beta-blockers for hypertension. Cochrane Database Syst Rev. 2007;(1):CD002003.
9. Olsson G., Tuomilehto J., Berglund G. et al. Primary prevention of sudden cardiac death in hypertensive patients. Mortality results from the MAPHY study. Am J Hypertens 1991;4(2 Pt 1):151-8.
10. Herlitz J., Waagstein F., Lindqvist J. et al. Effect of metoprolol on the prognosis for patients with suspected acute myocardial infarction and indirect signs of congestive heart failure (a subgroup analysis of the Göteborg Metoprolol Trial). Am J Cardiol 1997;80(9B):40J-44J.
11. Olsson G., Rehnqvist N., Sjögren A. et al. Long-term treatment with metoprolol after myocardial infarction: effect on 3 year mortality and morbidity. J Am Coll Cardiol 1985;5(6):1428-37.
12. Metoprolol in acute myocardial infarction (MIAMI). A randomised placebo-controlled international trial. The MIAMI Trial Research Group. Eur Heart J 1985;6(3):199-226.
13. Waagstein F., BristowM.R., SwedbergK. et al. Beneficial effects of metoprolol in idiopathic dilated cardiomyopathy. Metoproloi inDilated Cardiomyopathy (MDC) Trial Study Group. Lancet 1993;342(8885): 1441-6.
14. Klein G., Bergerl., Olsson G., et al.Adouble-blind comparison of metoprolol CR/ZOK 50 mg and atenolol 50 mg once daily for uncomplicated hypertension. J Clin Pharmacol 1990;30(2 Suppl):S72-S77.
15. Марцевич С.Ю., Лукина Ю.В.,Деев А.Л. и др. Сравнительное из- учение нового препарата метопролола тартрата пролонгиро- ванного действия — эгилока ретард и оригинального препарата метопролола сукцината — беталока зок у больных мягкой и умеренной артериальной гипертонией. Рациональная Фармакотерапия в Кардиологии 2005;1(3):35-40.
16. Шальнова С.А., Деев А.Д., Вихирева О.В. и др. Распространенность артериальной гипертонии в России. Информированность, лечение, контроль. Профилактика заболеваний и укрепления здоровья 2001;(2):3-7.
17. Salpeter S.R., Ormiston T.M., Salpeter E.E. Cardioselective beta-blockers in patient with reactive airway disease: a meta-analysis. Ann Intern Med 2002;137(9):715-25.
18. Маколкин В.И. Овчаренко С.И.Литвинова И.В. Возможности применения β-адреноблокаторов у больных с сопутствующей па- тологией. Тер Арх 2008;80(8):86-9.
19. Radack K., Deck C. Beta-adrenergic blocker therapy does not worsen intermittent claudication in subject with peripheral arterial disease. A meta-analysis of randomized controlled trials. Arch Intern Med 1991;151(9):1769-76.
20. Kostis J.B., Sanders M. The association of heart failure with insulin resistance and the development of type 2 diabetes. Am J Hypertens 2005;18(5 Pt 1):731-7
21. Галеева З.М., Галявич А.С. Эффективность и переносимость метопролола ретард при лечении больных артериальной гипертонией и ишемической болезнью сердца в сочетании с сахарным диабетом 2-го типа. Кардиология 2009;49(3):25-7.
Review
For citations:
Barbarash O.L., Zykov M.V. EFFICACY AND SAFETY OF CONTROLLED RELEASE METOPROLOL TARTRATE IN PATIENTS WITH ARTERIAL HYPERTENSION: ERA STUDY RESULTS. Rational Pharmacotherapy in Cardiology. 2010;6(2):160-165. (In Russ.) https://doi.org/10.20996/1819-6446-2010-6-2-160-165
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