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Metoprolol ER works by blocking the effects of adrenaline on beta receptors in the heart and blood vessels. This helps to reduce the heart rate, lower blood pressure, and decrease the workload on the heart, ultimately improving its efficiency and reducing the strain on the cardiovascular system.Metoprolol ER (extended-release) is a prescription medication that belongs to a class of drugs called beta-blockers. It is used to treat various cardiovascular conditions, including high blood pressure (hypertension), angina (chest pain), and certain types of heart rhythm disorders.