Bisoprolol and nifedipine retard in elderly hypertensive patients: effect on quality of life

Subjects over the age 60 with sustained sitting diastolic pressures of 95-1 15 mm Hg were randomised to a regime based on bisoprolol (n = 368) or nifed ipine retard (n = 379) for 24 weeks. The goal diastolic pressure was less t han or equal to 90 mm Hg and to achieve this, double-blind medication could be doubled (5/10 mg bisoprolol, 40/80 mg nifedipine retard) or hydrochloro thiazide 25 mg (unblinded) could be added to the higher dose. In an intenti on-to-treat analysis, 309 subjects in both the bisoprolol and nifedipine re tard treated group provided at least a baseline and a second quality of lif e assessment (82%), An excess of symptoms was observed in the nifedipine gr oup for oedema of the legs, nocturia, constipation, racing heart and heart thumping. Fewer patients reported wheeze in the nifedipine group. For quali ty of life, there were no statistically significant differences between the two groups after 8 weeks, However, when analysing the results of the last available assessment (usually at 24 weeks) there were significant (P < 0.05 ) improvements in tension/anxiety, anger/hostility, vigour/activity, and co nfusion/bewilderment, assessed by the Profile of Mood States (POMS) in pati ents receiving bisoprolol in comparison to those receiving nifedipine retar d. The Sickness Impact Profile and objective tests of cognitive function di d not differ statistically between the two groups, Quality of life was main tained at a good level on both treatments with advantages for bisoprolol in certain areas.