Impact of antihypertensive treatment on quality of life: comparison between bisoprolol and bendrofluazide

Objectives: To compare quality of life with the selective beta(1)-blocker b isoprolol and the thiazide diuretic bendrofluazide in patients with mild to moderate hypertension. Design and setting: Multi centric, randomised, double-blind, two-way crosso ver study carried out at six general practice centres. Subjects: Eighty-one patients with newly diagnosed or previously treated hy pertension, who had a mean diastolic blood pressure (BP) of 95-120 mm Hg af ter receiving placebo for 4-6 weeks. Interventions: In random order, patients received bisoprolol (5 mg once dai ly) or bendrofluazide (2.5 mg once daily) for 8 weeks. Main outcome measures: Quality of life and antihypertensive effect. Results: Decrease in systolic/diastolic BP did not differ between bisoprolo l (10 +/- 2/13 +/- 1 mm Hg) and bendrofluazide (9 +/- 2/11 +/- 1 mm Hg). Be tween bisoprolol and bendrofluazide neither in the intention-to-treat nor i n the efficacy analysis any difference was found in quality of life variabl es, such as Health Status Index, somatic symptoms, anxiety, depression, tot al psychiatric morbidity, cognitive symptoms and hostility score. Compared to baseline the Health Status Index improved (P < 0.05) during bisoprolol. None of the other investigated quality of life variables changed compared t o baseline. No patients dropped out during bisoprolol or bendrofluazide tre atment. Although, the total number of reported adverse events appeared lowe r during bendrofluazide than during bisoprolol treatment, it is unclear whe ther drug related adverse events also differ between the two drugs. Conclusions: At equipotent antihypertensive dosages, the effect of an 8-wee k treatment on quality of life does not differ between the selective beta(1 )-blocker bisoprolol and the thiazide diuretic bendrofluazide.