[Effects of metoprolol on the peripheral circulation in patients with peripheral vascular disease]

Up to now betablockers were regarded as relatively contraindicated in patients with peripheral vascular disease (PVD). The effects of metoprolol were studied in hypertensive patients (stage I, WHO) with PVD of pelvic and thigh type (stage II according to Fontaine). An initial dose of 100 mg metoprolol followed by 100 mg 90 min after the first oral administration, twice a day was administered for 8 weeks. Blood pressure decreased from 181/105 to 163/96 mm Hg. Pulse rate was lowered from 72 to 68/min (p less than 0.001). Estimated doppler pressure in the posterior tibial artery decreased from 123 to 119 mm Hg. Venous occlusion plethysmography showed a slight but not significant decrease at rest and during reactive hyperemia. During long-term treatment the pain-free walking distance increased significantly from 225 to 348 m. No side effects were seen. Thus, metoprolol as a beta 1-selective betablocker is not contraindicated in patients with intermittent claudication.