A15294 Effects of Antihypertensive Therapy on Cognitive Function and Health-related Quality of Life in High-risk Hypertensive Patients

Abstract

Objectives: Recent evidence has indicated that hypertension is associated with impaired cognitive function and health-related quality of life (HRQoL). However, the prevention of cognitive disorders and improvement of HRQoL with antihypertensive therapy remains controversial. The trial was to compare the efficacy on cognitive function with the combination of amlodipine with diuretics and angiotensin II receptor blocker. Methods: In a prospective, randomized, open-label, blinded-endpoint trial, 13542 hypertensive patients at high risk for cardiovascular events were assigned to receive treatment with either amlodipine 2.5–5 mg plus amiloride/hydrochlorothiazide 1.25–2.5 mg/12.5–25 mg or telmisartan 40–80 mg. The Mini-Mental State Examination (MMSE) was used for the comprehensive assessment of cognitive function and the European Quality of Life-5 Dimensions (EQ-5D) comprising EQ-5D Index and EQ visual analogue scale (EQ VAS) was for HRQoL. Results: The median follow-up was 41 months. At the end of the trial, the mean blood pressures and control rates were similar between the two groups. There was no significant between-group difference for MMSE scores and HRQoL. However, a significant correlation was observed between the magnitude of BP decrement and the increase of MMSE scores and the improvement of HRQoL. Compared with the baseline, the difference of mean MMSE scores, the EQ-5D index and the EQ VAS was 0.36, 0.03, 1.62 respectively (p < 0.001; p < 0.001; p = 0.030) between patients with systolic blood pressure of 130–140 mmHg and ≥140mmHg. Conclusion: Blood pressure lowering is associated with the improvement of cognitive function and health-related quality of life in high-risk hypertensive patients, but not the specific antihypertensive drugs. (ClinicalTrials.gov number, NCT01011660.)