ANTIHYPERTENSIVE THERAPY AND QUALITY-OF-LIFE - INFLUENCE OF BLOOD-PRESSURE REDUCTION, ADVERSE EVENTS, AND PRIOR ANTIHYPERTENSIVE THERAPY

Quality of life is an important attribute of antihypertensive therapy. Previous studies have not addressed the importance of a patient's pri or pharmacotherapy on quality of life, which may serve as the basis of reference for a new therapy. Nor have previous studies compared commo nly used quality of life instruments for consistency, or investigated whether improvement or worsening of quality of life correlates with ad verse events or blood pressure reduction. Two hundred eighteen hyperte nsive patients with diastolic blood pressure (95 to 114 mm Hg) after a 4- to 5-week placebo washout period were enrolled in a randomized dou ble-blind, parallel group dose-escalation trial to compare the effects of amlodipine (2.5 to 10 mg), bisoprolol(2.5 to 10 mg)/hydrochlorothi azide (HCTZ) 6.25, and enalapril (5 to 20 mg) on blood pressure, adver se events, and quality of life. Three quality of life instruments (Gen eral Well-Being Index, Vital Signs Quality of Life, Zung Self-Rating D epression Scale) were administered during original therapy, after plac ebo washout, and after 12 weeks of optimally titrated clinical trial p harmacotherapy. Our results demonstrated that removal from prior thera py had no detectable influence on subsequent evaluation of quality of life. The three quality of life instruments were consistent with the c hanges observed with the three therapies: a trend toward better qualit y of life with amlodipine and bisoprolol/HCTZ. Adverse events, but not systolic or diastolic blood reduction correlated directly with change s in quality of life.