Bisoprolol and nifedipine retard in elderly hypertensive patients: effect on quality of life.
Subjects over the age 60 with sustained sitting diastolic pressures of 95-115 mm Hg were randomised to a regime based on bisoprolol (n = 368) or nifedipine retard (n = 379) for 24 weeks. The goal diastolic pressure was < or =90 mm Hg and to achieve this, double-blind medication could be doubled (5/10 mg bisoprolol, 40/80 mg nifedipine retard) or hydrochlorothiazide 25 mg (unblinded) could be added to the higher dose. In an intention-to-treat analysis, 309 subjects in both the bisoprolol and nifedipine retard treated group provided at least a baseline and a second quality of life assessment (82%). An excess of symptoms was observed in the nifedipine group for oedema of the legs, nocturia, constipation, racing heart and heart thumping. Fewer patients reported wheeze in the nifedipine group. For quality of life, there were no statistically significant differences between the two groups after 8 weeks. However, when analysing the results of the last available assessment (usually at 24 weeks) there were significant (P < 0.05) improvements in tension/anxiety, anger/ hostility, vigour/activity, and confusion/bewilderment, assessed by the Profile of Mood States (POMS) in patients receiving bisoprolol in comparison to those receiving nifedipine retard. The Sickness Impact Profile and objective tests of cognitive function did not differ statistically between the two groups. Quality of life was maintained at a good level on both treatments with advantages for bisoprolol in certain areas. Journal of Human Hypertension (2000) 14, 205-212.
Bulpitt
C J
CJ
Section of Care of the Elderly, Imperial College School of Medicine, Hammersmith Hospital, London, UK. The European Bisoprolol Trial Inestigators.
Connor
M
M
Schulte
M
M
Fletcher
A E
AE
D000318:Adrenergic beta-Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D000339:Affect / Q000187:drug effects; D000368:Aged; D000375:Aging / Q000502:physiology*; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D017298:Bisoprolol / Q000009:adverse effects / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000009:adverse effects / Q000627:therapeutic use*; D011788:Quality of Life
D000318:Adrenergic beta-Agonists; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D009543:Nifedipine; D017298:Bisoprolol