The effects of antihypertensive agents on the quality of life in Indian hypertensives

Abstract

Effects of commonly used antihypertensive agents like nifedipine, atenolol, propranolol and captopril on quality of life was studied. Fourty-four patients with essential hypertension entered and 26 completed the full protocol of the study. Each drug was given separately in a random fashion in fixed dosage for 4 weeks with a washout period of 2 weeks in between the drugs. Assessment of quality of life was done under following measures: satisfaction with life and sense of well being, physical state, emotional state, intellectual function, social life and sexual life; each assessed on a prestandardized 5 point scale. All the 4 drugs resulted in significant and similar blood pressure control but the incidence of adverse effects was maximum with nifedipine (40.9%), followed by atenolol (18.4%), propranolol (14.3%) and captopril (3.6%). There was significant improvement in various aspects of quality of life with all the 4 drugs. Captopril and propranolol scored significantly better than atenolol and nifedipine on measures like sense of well being and satisfaction with life, physical state, intellectual function and emotional state. Improvement in sexual life was maximum with captopril, moderate with propranolol and nifedipine and least with atenolol. In conclusion, captopril closely followed by propranolol was the most acceptable drug with fewer adverse effects and improved sexual as well as other aspects of quality of life compared to nifedipine and atenolol.