EFFECT OF BLOOD-PRESSURE CONTROL AND ANTIHYPERTENSIVE DRUG REGIMEN ONQUALITY-OF-LIFE - THE AFRICAN-AMERICAN STUDY OF KIDNEY-DISEASE AND HYPERTENSION (AASK) PILOT-STUDY

The African American Study of Kidney Disease and Hypertension (AASK) P ilot Study evaluated the feasibility of carrying out a randomized, mul ticenter, 7-year clinical trial to determine the effects of two goal l evels of blood pressure control and three antihypertensive drug regime ns on decline in glomerular filtration rate in African Americans with clinically diagnosed hypertensive nephrosclerosis. Participants were r andomized to either a usual mean arterial blood pressure (MAP) goal gr oup (102-107 mm Hg) or a low-MAP goal group (less than or equal to 92 mm Hg) and to a drug regimen (initial therapy with either atenolol, am lodipine, or enalapril). Quality of life was assessed by the Medical O utcomes Short-Form 36 (MOS SF-36) at baseline and the last follow-up v isit for 84 of the 94 participants of the AASK Pilot Study. Symptoms w ere assessed at baseline and throughout the course of therapy by parti cipant self-report. Mean SF-36 scores increased significantly on physi cal functioning (9.2), role limitations (physical) (19.0), social func tioning (9.0), and vitality dimensions (5.6) from baseline to the last follow-up visit in the usual MAP goal group. Scores for the eight hea lth dimensions assessed by the MOS SF-36 did not change significantly during the same time period either in the low-MAP goal group or in any of the drug regimens. The mean score for general health perception wa s significantly lower at the last follow-up visit in the enalapril dru g regimen (49.9) compared to drug regimens with atenolol (65.4) or aml odipine (63.9). Physical functioning, role limitations (emotional), so cial functioning, mental health, vitality, and general health percepti on scores were negatively correlated with self-reported symptoms durin g treatment. We conclude that selected dimensions of quality of life i mproved during the AASK Pilot Study only in participants randomized to the usual MAP goal group. Significant differences between MAP goal gr oups and drug regimens at the end of follow-up were observed for only a few health dimensions.