Effects of metoprolol CR/XL on mortality and hospitalizations in patients with heart failure and history of hypertension

Johan Herlitz, John Wikstrand, Marty Denny, Paul Fenster, Thomas Heywood, Gabriella Masszi, Sten Rasmussen, Gudmundur Thorgeirsson, Kristian Wachtell

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Background: We describe the effect of controlled-release/extended-release (CR/XL) metoprolol succinate once daily on mortality and hospitalizations among patients with a history of hypertension complicated by chronic systolic heart failure. Methods and Results: We enrolled 3,991 patients with chronic heart failure of New York Heart Association functional class II-IV with an ejection fraction of ≤0.40, stabilized with optimum standard therapy, in a double-blind randomized placebo-controlled study. A total of 1,747 patients (44%) had a history of hypertension; 871 were randomized to receive metoprolol CR/XL and 876 to receive placebo. Treatment with metoprolol CR/XL compared with placebo resulted in a significant reduction in total mortality (relative risk [RR], 0.61; 95% confidence interval [CI], 0.44-0.84; P =. 0022), mainly because of reductions in sudden death (RR, 0.51; 95% CI, 0.33-0.79; P =. 0022) and mortality from worsening heart failure (RR, 0.49; 95% CI, 0.25-0.99; P =. 042). Total number of hospitalizations for worsening heart failure was reduced by 30% in the metoprolol CR/XL group compared with placebo (P =. 015). Metoprolol CR/XL was well tolerated: 12% fewer patients withdrew from study medication (all-cause) compared with placebo (P =. 048). Conclusions: A subgroup analysis of MERIT-HF shows that patients with heart failure and a history of hypertension received a similar benefit from metoprolol CR/XL treatment as all patients included in the total study.

Original languageEnglish (US)
Pages (from-to)8-14
Number of pages7
JournalJournal of cardiac failure
Issue number1
StatePublished - 2002


  • Heart failure
  • Hypertension
  • Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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