title: Relation of hostility to medication adherence, symptom complaints, and blood pressure reduction in a clinical field trial of antihypertensive medication.
abstract: The impact of hostility was examined in relation to the conduct and results of a clinical field trial. Data were derived from a multi-center randomized double-blind study of the comparative effects of antihypertensive therapy (captopril, methyldopa and propranolol) on the quality of life of 620 hypertensive men. Hostility levels were higher in subjects reporting skipping medication dosages compared to those reporting they always complied with the medication schedule. Reporting of symptoms often associated with antihypertensive drug regimens was positively related to hostility scores throughout the study, even during the blinded placebo period. Persons with high hostility scores showed the greatest decline in blood pressure independent of type of antihypertensive medication. However, there was some limited evidence that hostility levels were significantly reduced by one antihypertensive medication. Overall, the present findings suggest that double-blind pharmacologic clinical trials may benefit from using reliable measures of hostility as covariates in the evaluation of symptom reports and amount of blood pressure reduction.
authors.affiliation: Department of Epidemiology and Public Health, University of Miami School of Medicine, Florida.
authors.forename: D
authors.initials: D
authors.lastname: Lee
authors.forename: C F
authors.initials: CF
authors.lastname: Mendes de Leon
authors.forename: C D
authors.initials: CD
authors.lastname: Jenkins
authors.forename: S H
authors.initials: SH
authors.lastname: Croog
authors.forename: S
authors.initials: S
authors.lastname: Levine
authors.forename: A
authors.initials: A
authors.lastname: Sudilovsky
mesh_terms: D000328:Adult; D000786:Anger / Q000187:drug effects; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D002216:Captopril / Q000009:adverse effects / Q000627:therapeutic use; D006791:Hostility; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000523:psychology; D008297:Male; D008750:Methyldopa / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D010555:Personality Inventory; D011433:Propranolol / Q000009:adverse effects / Q000627:therapeutic use; D011788:Quality of Life; D012803:Sick Role
chemical_list: D000959:Antihypertensive Agents; D008750:Methyldopa; D002216:Captopril; D011433:Propranolol