Effect of treatment on the quality of life in hypertension and congestive heart failure.

Abstract

The objective in the treatment of hypertension is to preserve the quality of life. Most patients with hypertension do not have any impairment to their quality of life and the objective of treatment is to preserve this well-being. The results of trials in Europe and in the USA are discussed in this communication. At entry to the European trials, younger men appeared to have a better quality of life than older hypertensive men but older hypertensive women appeared, in some respects, to have a better quality of life than younger women. Following treatment the younger patients, aged less than 60 years, appeared to improve most with captopril and did not improve with methyldopa. However, in contrast, the elderly patients appeared to improve with both methyldopa and captopril. A large American trial confirmed that in white working men with hypertension the quality of life was best with treatment with captopril, least good with methyldopa and intermediate with propranolol. With congestive heart failure there are very few studies on the quality of life that can be discussed. However, Lipkin and Poole-Wilson did review the changes in exercise capacity with different drugs employed for the treatment of congestive heart failure. They assessed 16 trials that included the New York Heart Association Classification as an outcome. The reviewers did not consider that the inotropic agents improved exercise capacity. They considered that some of the trials supported a benefit from vasodilator treatment and that the four trials which assessed angiotensin-converting enzyme inhibitor therapy all showed an improvement in exercise capacity.(ABSTRACT TRUNCATED AT 250 WORDS)