Document Detail

Primary prevention with metoprolol in patients with hypertension. Mortality results from the MAPHY study.
MedLine Citation:
PMID:  3346979     Owner:  NLM     Status:  MEDLINE    
The present study of primary prevention in white men aged 40 to 64 years attempts to investigate whether a beta-blocker given as initial antihypertensive treatment would lower total mortality to a greater extent than thiazide diuretics. Patients were randomized to metoprolol (n = 1609, 8110 patient-years) or a thiazide diuretic (n = 1625, 8070 patient-years). The median follow-up time was 4.2 years. The mean dose of metoprolol was 174 mg/d, and of thiazide diuretics, 46 mg/d of hydrochlorothiazide or 4.4 mg/d of bendroflumethiazide. Identical control of blood pressure was achieved using a fixed therapeutic schedule. Total mortality was significantly lower for metoprolol than for thiazide diuretics because of fewer deaths from coronary heart disease and stroke. Total mortality was also significantly lower in smokers randomized to metoprolol. The benefit demonstrated in patients treated with metoprolol seems to have important implications for clinical practice.
J Wikstrand; I Warnold; G Olsson; J Tuomilehto; D Elmfeldt; G Berglund
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JAMA     Volume:  259     ISSN:  0098-7484     ISO Abbreviation:  JAMA     Publication Date:  1988 Apr 
Date Detail:
Created Date:  1988-04-19     Completed Date:  1988-04-19     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1976-82     Citation Subset:  AIM; IM    
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MeSH Terms
Cardiovascular Diseases / etiology,  mortality,  prevention & control*
Cerebrovascular Disorders / mortality
Coronary Disease / mortality
Drug Therapy, Combination
Follow-Up Studies
Hypertension / drug therapy*
Metoprolol / therapeutic use*
Middle Aged
Random Allocation
Sodium Chloride Symporter Inhibitors / therapeutic use*
Reg. No./Substance:
0/Benzothiadiazines; 0/Diuretics; 0/Sodium Chloride Symporter Inhibitors; GEB06NHM23/Metoprolol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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