QUALITY-OF-LIFE WITH 3 ANTIHYPERTENSIVE TREATMENTS - CILAZAPRIL, ATENOLOL, NIFEDIPINE
QUALITY-OF-LIFE WITH 3 ANTIHYPERTENSIVE TREATMENTS - CILAZAPRIL, ATENOLOL, NIFEDIPINE
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DOI：
10.1161/01.hyp.19.6.499
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发表时间：
1992-06-01
期刊：
影响因子：
8.3
通讯作者：
NEISS, AM
中科院分区：
文献类型：
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作者：
FLETCHER, AE;BULPITT, CJ;NEISS, AM
在540例轻中度原发性高血压患者（平均年龄54岁，57%为男性）中进行了为期6个月的多中心、随机、双盲研究，以确定西拉普利、阿替洛尔和硝苯地平缓释剂对生活质量的相对影响。生活质量的评估使用自填式和访谈者管理的问卷;评估包括投诉评分（症状检查表），健康状况指数，工作满意度评估，心理总体幸福指数，情绪状态分量表的配置文件，和生活满意度评估。用Reitan连线测验B测量心理功能。在试验结束时，三组的舒张压平均下降了B 15 mm Hg，但与服用阿替洛尔（25%）或硝苯地平缓释剂（24%）的患者相比，服用西拉普利（36%）的患者需要添加利尿剂的比例显著增加（p=0.001）。在试验期间，西拉普利和阿替洛尔之间的生活质量没有显著差异。硝苯地平缓释剂组的症状投诉增加（p=0.02），导致较高的停药率（21%停止治疗，而阿替洛尔和西拉普利分别为13%和14%，p=0.04）。然而，也观察到硝苯地平缓释剂可能改善疲劳子量表（p=0.04）。95%置信区间显示，本试验中没有一种药物产生与先前报道的在心理总体健康指数中卡托普利与甲基多巴之间或在连线测试B中卡托普利与甲基多巴或普萘洛尔之间等效的效果。我们的结论是西拉普利和阿替洛尔对生活质量的影响相当，但硝苯地平缓释剂与更多的症状性投诉和更高的停药率相关。
A multicenter, randomized double-blind study of 6 months' duration was performed in 540 patients (average age 54 years, 57% male) with mild-to-moderate essential hypertension to determine the relative effects on quality of life of cilazapril, atenolol, and nifedipine retard. Quality of life was assessed by using both a self-administered and an interviewer-administered questionnaire; the assessment included a complaint score (symptoms checklist), Health Status Index, assessment of work satisfaction, Psychological General Well-being Index, Profile of Mood States subscales, and life satisfaction assessment. Psychomotor function was measured by the Reitan Trail Making test B. At the end of the trial, diastolic blood pressure had fallen b an average of 15 mm Hg in all three groups, but significantly (p=0.001) more patients taking cilazapril required the addition of a diuretic (36%) compared with those taking atenolol (25%) or nifedipine retard (24%). No significant differences in quality of life were observed between cilazapril and atenolol during the trial. Symptomatic complaints increased on nifedipine retard (p=0.02) and contributed to a higher discontinuation rate (21% discontinued treatment compared with 13% and 14% taking atenolol and cilazapril, respectively, p=0.04). However, a possible improvement in the fatigue subscale (p=0.04) was also observed on nifedipine retard. The 95% confidence intervals showed that none of the drugs in this trial produced an effect equivalent to that previously reported between captopril and methyldopa in the Psychological General Well Being Index or between captopril and methyldopa or propranolol in Trail Making test B. We conclude that cilazapril and atenolol have equivalent effects on quality of life, but nifedipine retard was associated with more symptomatic complaints and a higher discontinuation rate.