Quality of life on antihypertensive therapy: a randomized double-blind controlled trial of captopril and atenolol


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Abstract

A randomized double-blind study lasting 2 months was performed with either 25 mg captopril twice a day or 50 mg atenolol once a day in 125 patients with established diastolic hypertension (diastolic blood pressure>95 mmHg) identified during a population screening programme of subjects aged<65 years. Quality of life was assessed from self-completed questionnaires. A significant fall in diastolic blood pressure occurred with both captopril (106.7 ± 7.0 to 98.6 ± 8.6 mmHg) and atenolol (107.4 dh 7.5 to 98.2 ± 8.1 mmHg) but there was no difference between the two drugs in the size of the fall. A measure of the number of symptomatic complaints, the symptom complaint rate, decreased with both drugs, by 1.3% for captopril and 3.1% for atenolol, but the difference between the drugs was not significant [1.8%; 95% confidence interval (Cl-13%, 4.9%]. There was a significant increase in the reporting of cough and runny nose in those on captopril compared with atenolol. A health index increased by 1.1% with captopril in comparison with no change on atenolol (difference 1.1%; 95% Cl — 2.0%, 4.2%). Psychological well-being was measured using the Symptom Rating Test. The improvement in total score was 1.4% with captopril and 2.3% with atenolol. The difference of 0.9% was not statistically significant (95% Cl - 1.2%, 3.0%). In the Symptom Rating Test subscales there was a tendency for atenolol to reduce anxiety more than captopril, — 0.6 units against — 0.1 units (difference 0.5 units, 95% Cl — 0.2, 1.2), for captopril to reduce depression more than atenolol, — 0.4 units against — 0.1 (difference 0.3, 95% Cl — 0.2, 1.2) and atenolol to reduce hostility more than captopril, - 0.7 against -0.2 (difference 0.5, 95% Cl - 0.3, 1.3). This trial on 125 patients followed for 2 months did not reveal any differences in quality of life between the two treatments. It is concluded that, overall, the quality-of-life measures during atenolol treatment were similar to those during captopril. However, important differences in measures of anxiety, depression and hostility could not be excluded with confidence.

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