The control of blood pressure over a two year period was observed in two groups of hypertensive patients treated with either of the two cardio-selective beta-adrenergic blocking drugs, atenolol or metoprolol. Both groups were well matched during the run-in period in terms of their resting heart rate and blood pressure levels. After three months treatment, following a dose response period of four weeks, both groups had similar falls in blood pressure (p<0.001). Each patient was then treated with the other drug for three months. Absolute values of heart rate and blood pressure were identical after the cross over period. During the next twelve months of treatment, both groups had similar further small reductions in average blood pressure.At the end of the trial 80% of both groups were controlled on either lOOmg or 200mg of either drug daily and the rest required an additional diuretic. The incidence of intolerable side effects was 28% on atenolol compared with 8% on metoprolol.The study confirmed that both drugs were equally effective in controlling blood pressure, but the incidence of side-effects may vary.
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