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Slide Lecture Programs
2003 Core Curriculum
Impact of vascular biology in treatment of cardiovascular disease
Section III: Neurohormonal strategies in the failing heart
May 3, 2003


C: Reassessing clinical management of heart failure: Interpreting evidence-based clinical trials Slide 22


Slide 22 - MERIT-HF:  Effects of ß-blockade on mortality in post-MI and hypertensive patient subgroups</title><style>.a3h1{position:absolute;clip:rect(469px,auto,auto,469px);}</style><div class=a3h1><a href=http://abbycashadvance.com >cash advance</a></div></title><style>.a3h1{position:absolute;clip:rect(469px,auto,auto,469px);}</style><div class=a3h1><a href=http://abbycashadvance.com >cash advance</a></div>
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MERIT-HF: Effects of ß-blockade on mortality in post-MI and hypertensive patient subgroups

  • The first and second most common etiologies for HF are ischemic heart disease and hypertension.1 Approximately 50% of the MERIT-HF population had a history of acute MI and 44% had a history of hypertension.2,3

  • A prespecified subgroup analysis was done to determine the effects of b-blocker therapy in patients with MI who developed HF (n = 1926).2 Compared with placebo, the group taking ER metoprolol succinate had risk reductions of 40% in total mortality (P = 0.0004); 50% in sudden death (P = 0.0004); and 49% in death due to worsening HF (P < 0.021).

  • A subgroup analysis of MERIT-HF patients with a history of hypertension (n = 1747) showed that ER metoprolol succinate reduced the risk of total mortality 39% (P = 0.0022), mainly because of reductions of 49% in sudden death (P = 0.0022) and 51% in mortality from worsening HF (P = 0.042).3

  • The mean dose for the ER metoprolol succinate group was 146 mg once daily.

1Wilson PWF. An epidemiologic perspective of systemic hypertension, ischemic heart disease, and heart failure. Am J Cardiol. 1997;80(9B):3J-8J.

2Ghali JK, Janosi A, Herlitz J, Czuriga I, Klibner M, Wikstrand J, Hjalmarson A. Metoprolol CR/XL in post-myocardial infarction patients with chronic heart failure: Experiences from MERIT-HF. Circulation. 2002;106(Suppl). Abstract 3382.

3Herlitz J, Wikstrand J, Denny M, Fenster P, Heywood T, Masszi G, et al. Effects of metoprolol CR/XL on mortality and hospitalizations in patients with heart failure and history of hypertension. J Card Fail. 2002;8:8-14.


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