title: Quality of life measured in a practice-based hypertension trial of an angiotensin receptor blocker.
abstract: Effectiveness of antihypertensive treatment depends not only on drugs that avoid or minimize symptomatic side effects but also on therapy that has a positive effect on quality of life. This study assessed the effect on quality of life of a contemporary agent (an angiotensin receptor blocker) and evaluated the validity and practicality of using a quality-of-life instrument in the practice-based setting. A total of 2716 hypertensive patients, either untreated or on single-agent therapy, were started on or switched to 40 mg telmisartan for 6 weeks; in patients whose blood pressures remained above 130/85 mm Hg after 2 weeks, the dose was increased to 80 mg for the remaining 4 weeks of treatment. Quality of life was measured by patient self-administration of the Psychological General Well-Being Index (GWBI) at baseline and at the end of the study. Sixty-eight percent (n=1858) of patients treated with telmisartan fully completed both GWBI tests; the test score increased by 5.2+/-0.3 (p<0.0001) from 77.7+/-0.4. This improvement was observed across all six emotional and health subscales of the GWBI. White and black patients, those aged <65 or >/=65 years, and men and women had similar increases, though the baseline value in women was sharply lower (p<0.001) than in men. The GWBI rose more in patients whose blood pressure was controlled by treatment (<140/90 mm Hg) than in noncontrolled patients (6.1 vs. 4.1, p<0.0001); for all patients the decreases in systolic and diastolic blood pressures produced by telmisartan correlated significantly (p<0.001 for each) with the increases in the GWBI scores. Controlling blood pressure appears to be an important element in improving subjective health perceptions of hypertensive patients.
authors.affiliation: State University of New York Downstate College of Medicine, Brooklyn, NY 11203, USA. michaelwebermd@cs.com
authors.forename: Michael A
authors.initials: MA
authors.lastname: Weber
authors.forename: George L
authors.initials: GL
authors.lastname: Bakris
authors.forename: Joel M
authors.initials: JM
authors.lastname: Neutel
authors.forename: Giora
authors.initials: G
authors.lastname: Davidai
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Giles
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D000368:Aged; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001562:Benzimidazoles / Q000008:administration & dosage / Q000627:therapeutic use; D001565:Benzoates / Q000008:administration & dosage / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D015331:Cohort Studies; D003971:Diastole / Q000187:drug effects / Q000502:physiology; D004232:Diuretics / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011945:Receptors, Angiotensin / Q000008:administration & dosage / Q000627:therapeutic use*; D013223:Statistics as Topic; D013599:Systole / Q000187:drug effects / Q000502:physiology; D000077333:Telmisartan; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001565:Benzoates; D002121:Calcium Channel Blockers; D004232:Diuretics; D011945:Receptors, Angiotensin; D000077333:Telmisartan