Low-Dose Metoprolol CR/XL and Fluvastatin Slow Progression of Carotid Intima-Media Thickness

Abstract

Background—Statins reduce cardiovascular events and progression of carotid intima-media thickness (IMT). β-Blockers are also known to reduce cardiovascular events, but less is known about their effects on carotid IMT. Methods and Results—We conducted a randomized, double-blind, placebo-controlled, single-center trial to compare the effects of low-dose metoprolol CR/XL (25 mg once daily) and fluvastatin (40 mg once daily) on the progression of carotid IMT during 36 months of treatment in 793 subjects who had carotid plaque but no symptoms of carotid artery disease. Changes in mean IMT in the common carotid artery and maximal IMT in the bulb were the main outcome variables. Death and cardiovascular events were monitored. Progression of IMTmax in the carotid bulb at both 18 and 36 months was reduced by metoprolol CR/XL (−0.058 mm/y; 95% CI, −0.094 to −0.023; P=0.004; and −0.023 mm/y; 95% CI, −0.044 to −0.003; P=0.014, respectively). Incidence of cardiovascular events tended to be lower in metoprolol CR/XL–tr...