Croog S H, Elias M F, Colton T, Baume R M, Leiblum S R, Jenkins C D, Perry H M, Hall W D
Department of Behavioral Sciences and Community Health, University of Connecticut Health Center, Farmington 06030.
Am J Hypertens. 1994 Apr;7(4 Pt 1):329-39. doi: 10.1093/ajh/7.4.329.
The impact of antihypertensive medications on the quality of life of elderly hypertensive women has rarely been systematically evaluated in large clinical trials using drugs from the new generations of pharmaceutic preparations. We carried out a multicenter, randomized double-blind clinical trial with 309 hypertensive women aged 60 to 80 years to assess effects of atenolol, enalapril, and isradipine on measures of quality of life over a 22-week period. The patients had mild to moderate hypertension. Hydrochlorothiazide was added to treatment if monotherapy was inadequate in lowering blood pressure. At the conclusion of the trial the three drug groups did not differ in degree of reduction of diastolic blood pressure or in supplementation with hydrochlorothiazide. Over the 22-week trial, linear trend analysis showed no differences between the treatment groups in change from baseline on quality of life measures of well-being, physical status, emotional status, cognitive functioning, and social role participation. Regarding each of 33 physical side effects over the 22 weeks, we found no general difference between atenolol, enalapril, and isradipine groups on measures of change in distress over symptoms except for enalapril patients who worsened in distress over cough (P = .001) and atenolol patients who worsened in distress over dry mouth (P = .014). Centering on three medications that are relatively new additions to the armamentarium for blood pressure control, the findings underline the increasing opportunities for the physician to select drugs that can control blood pressure while maintaining the quality of life of elderly hypertensive women.
在大型临床试验中，利用新一代药物制剂中的药物，很少系统评估抗高血压药物对老年高血压女性生活质量的影响。我们对309名年龄在60至80岁的高血压女性进行了一项多中心、随机双盲临床试验，以评估阿替洛尔、依那普利和伊拉地平在22周期间对生活质量指标的影响。这些患者患有轻度至中度高血压。如果单一疗法在降低血压方面不足，则添加氢氯噻嗪进行治疗。在试验结束时，三个药物组在舒张压降低程度或添加氢氯噻嗪方面没有差异。在为期22周的试验中，线性趋势分析表明，治疗组在幸福感、身体状况、情绪状况、认知功能和社会角色参与等生活质量指标从基线的变化方面没有差异。关于22周内的33种身体副作用中的每一种，我们发现阿替洛尔、依那普利和伊拉地平组在症状困扰变化指标上没有总体差异，但依那普利患者咳嗽困扰加重（P = .001），阿替洛尔患者口干困扰加重（P = .014）除外。以三种相对较新添加到血压控制药物库中的药物为中心，这些发现强调了医生在选择能够控制血压同时维持老年高血压女性生活质量的药物方面有越来越多的机会。
