From the Guidelines
Metoprolol succinate is effective in lowering blood pressure in patients with hypertension, with a recommended starting dose of 25-50 mg once daily, titrated up to 200 mg daily as needed, as supported by the most recent and highest quality study 1. The mechanism of action of metoprolol succinate involves blocking beta-1 adrenergic receptors in the heart, reducing heart rate and cardiac output. Some key points to consider when using metoprolol succinate for blood pressure management include:
- The extended-release formulation provides 24-hour coverage with once-daily dosing, improving adherence compared to immediate-release versions.
- Patients should take metoprolol consistently at the same time each day, with or without food.
- Blood pressure reduction typically begins within 1-2 weeks, with full effects seen after several weeks of treatment.
- Common side effects include fatigue, dizziness, and bradycardia.
- Metoprolol should never be stopped abruptly, as this can trigger rebound hypertension or cardiac events; dosage should be gradually tapered over 1-2 weeks when discontinuation is necessary, as noted in previous studies 1. Regular monitoring of heart rate and blood pressure is essential to ensure appropriate dosing and effectiveness. It's also important to note that metoprolol succinate is one of the four beta-blockers proven to reduce mortality in patients with heart failure, along with carvedilol, bisoprolol, and nebivolol, as stated in 1. However, carvedilol may be more effective in reducing blood pressure due to its combined alpha-1 and beta-1 blocking properties, as suggested in 1.
From the FDA Drug Label
In controlled clinical studies, metoprolol has been shown to be an effective antihypertensive agent when used alone or as concomitant therapy with thiazide-type diuretics, at oral dosages of 100 to 450 mg daily In controlled, comparative, clinical studies, metoprolol has been shown to be as effective an antihypertensive agent as propranolol, methyldopa, and thiazide-type diuretics, to be equally effective in supine and standing positions
The effect of metoprolol succinate on blood pressure in patients with hypertension is a reduction in blood pressure. Metoprolol has been shown to be an effective antihypertensive agent when used alone or as concomitant therapy with other medications, at oral dosages of 100 to 450 mg daily 2. Key points include:
- Effective antihypertensive agent: Metoprolol has been shown to be effective in reducing blood pressure in patients with hypertension.
- Dosage: Oral dosages of 100 to 450 mg daily have been used in clinical studies.
- Comparative effectiveness: Metoprolol has been shown to be as effective as other antihypertensive agents, such as propranolol, methyldopa, and thiazide-type diuretics.
From the Research
Effect of Metoprolol Succinate on Blood Pressure
- Metoprolol succinate is a beta-blocker that has been shown to be effective in reducing blood pressure in patients with hypertension 3, 4.
- The medication works by blocking the effects of the hormone epinephrine, also known as adrenaline, and by slowing the heart rate and reducing its workload 4.
- Studies have demonstrated that metoprolol succinate is at least as effective as other beta-blockers, diuretics, and certain calcium antagonists in reducing blood pressure in patients with hypertension 3.
Comparison with Other Medications
- A study comparing metoprolol succinate with amlodipine found that metoprolol succinate induced greater reductions in early morning blood pressure, heart rate, and rate-pressure product in patients with stages 1 and 2 hypertension 5.
- Another study found that metoprolol succinate was more effective than atenolol in sustaining 24-hour and early morning blood pressure reductions in hypertensive patients also treated with hydrochlorothiazide 6.
Clinical Implications
- The use of metoprolol succinate in combination with other medications, such as diuretics, may improve the overall response rate in hypertension 3, 4.
- Metoprolol succinate may be a useful treatment option for patients with hypertension and coronary heart disease, as it has been shown to reduce cardiovascular events and mortality in these patients 4, 5.
- The medication is generally well tolerated, with temporary fatigue, dizziness, and headache being among the most frequently reported side effects 3.