A multicenter, randomized double-blind clinical trial was
conducted among 306 black men and women with mild to moderate hypertension to determine effects of atenolol, captopril, and
verapamil SR on measures of quality of life. Patients were randomly assigned to a stable or forced-dose titration sequence.
After an 8-week treatment period, the rate of withdrawal from
treatment because of adverse effects was low and did not differ
by drug treatment group or titration level. Patients taking verapamil SR showed a significantly greater reduction in mean blood
pressures than patients treated with atenolol or captopril. Along
with absence of worsening on any quality of life total scale scores
examined over the treatment period, we found either improvement or no change in the total scale scores for all three treatment
groups. Among both male and female patients, comparisons
between drug treatment groups showed no differences in degree
of change on the total scale scores. In comparisons within each
treatment group, improvement in scores of male patients after 8
weeks appeared among those taking atenolol in general well-being and physical symptoms reduction; among male patients
taking captopril in general well-being, physical symptoms, and
sexual performance; and among male patients receiving verapamil SR in scores in irritability, sleep, and the Digit Span test.
Improvement in scores among female patients taking atenolol
was found in scores on general well-being, physical symptoms,
and sleep; among women taking captopril on general well-being,
physical symptoms, and irritability; and among women taking
verapamil SR on general well-being. Patients in all treatment
groups improved on measures of visuomotor functioning. The
research shows that with the three newer generation antihypertensive medications studied, blood pressure control was
achieved during the treatment period without negative effects on
quality of life scales, along with findings of improvement on
some measures. Given the special clinical features of hypertension in black patients, the study underlines as well the potential
and utility of systematic tracking of measures of quality of life,
while monitoring blood pressures in this patient population.
(Arch Intern Med. 1990;150:1733-1741)
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