THE EFFECTS OF REPLACING BETA-BLOCKERS WITH AN ANGIOTENSIN-CONVERTINGENZYME-INHIBITOR ON THE QUALITY-OF-LIFE OF HYPERTENSIVE PATIENTS

The aim was to evaluate the effects of a change of treatment from beta -blocker to captopril on the quality of life of hypertensive patients. One hundred forty-nine mild to moderate hypertensive patients who wer e being treated with beta-blockers were randomly assigned to receive c aptopril (12.5 to 50 mg twice daily), or to continue on beta-blocker t reatment (atenolol: 25 to 100 mg once daily [n = 121], or propranolol, 10 to 80 mg twice daily [n = 12]). When required, 25 mg hydrochloroth iazide was added in each group. The patients were followed over period s ranging from 6 to 12 months. Blood pressure, treatment side effects, and quality of life were monitored. Blood pressure was equally well m anaged in both groups, though a lower level of treatment was required in the captopril group. The captopril treated patients exhibited favor able changes in several aspects of quality of life: sleep-related, gas trointestinal, and physical activity-related symptoms improved from ba seline to end of follow-up. Drowsiness and the ability to concentrate significantly improved in the captopril group only (P <.01). Change in treatment from beta-blocker to captopril resulted in equally well con trolled blood pressure on a lower drug dose. Moreover, the change to c aptopril had a positive impact on the quality of life. (C) 1996 Americ an Journal of Hypertension, Ltd.