[Quality of life and psychosocial factors during treatment with antihypertensive drugs. A comparison of captopril and quinapril in geriatric patients].
BACKGROUND
There is an increasing prevalence of older adults (> 65 years) with hypertension and the need for antihypertensive medication. It is well established that elderly hypertensive patients benefit from drug treatment with regards to cardiovascular morbidity and mortality. Due to the comorbidity and reduced quality of life (QOL) in the elderly, drug-induced changes of well-being and QOL are especially important to maintain compliance and social abilities. Whereas in most studies different antihypertensive agents exerted similar influences on QOL, Captopril was found to be superior to other antihypertensives in some trials.


METHODS
In this controlled non-randomized study 100 elderly hypertensive patients (mean age 75.4 +/- 7.2 years; 56% female) were treated with Captopril (25-50 mg twice daily) or the newer ACE-inhibitor Quinapril (5-20 mg per day). Blood pressure and QOL were recorded initially and after 6 months, assessment of QOL was based on a validated questionnaire (PLC).


RESULTS
Blood pressure fell from 153/82 mm Hg to 142/80 mm Hg with Captopril and 154/82 to 142/80 mm Hg [corrected] with Quinapril. An improvement of QOL was only seen with Quinapril, mainly due to better mood and lower depression scores. Analysis of underlying psychosocial factors on QOL found lack of social support, female sex and a current life event as additional significant negative influences on QOL.


CONCLUSIONS
A favorable antidepressive effect of Quinapril in elderly hypertensive patients is concluded and should be studied in further investigations.
Michalsen
A
A
Abteilung für Innere Medizin V, Kliniken Essen-Mitte.
Wenzel
R R
RR
Mayer
C
C
Broer
M
M
Philipp
T
T
Dobos
G J
GJ
D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002216:Captopril / Q000008:administration & dosage* / Q000009:adverse effects; D003863:Depression / Q000523:psychology; D005260:Female; D005783:Gender Identity; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000523:psychology; D007546:Isoquinolines / Q000008:administration & dosage* / Q000009:adverse effects; D008016:Life Change Events; D008297:Male; D011788:Quality of Life; D000077583:Quinapril; D012917:Social Adjustment; D012944:Social Support; D044005:Tetrahydroisoquinolines
D000959:Antihypertensive Agents; D007546:Isoquinolines; D044005:Tetrahydroisoquinolines; D002216:Captopril; D000077583:Quinapril
Lebensqualität und psychosoziale Faktoren unter antihypertensiver Therapie. Ein Vergleich von Captopril und Quinapril bei geriatrischen Patienten.