Antihypertensive drug side effects in the Hypertension Detection and Follow-up Program.

Abstract

The 5485 participants in the Hypertension Detection and Follow-up Program, Stepped-Care group form one of the largest groups to date on which detailed surveillance of long-term antihypertensive therapy and drug side effects has been reported. During a 5-year period, among all hypertensive persons (mild, moderate, and severe combined) who were not taking antihypertensive medications at the beginning of the study and who attended the clinic at least once during the 5-year trial, a total of 9.3% had definite or probable side effects severe enough to cause discontinuation of the drug treatment in question. Less than 1% of active participants required hospitalization for side effects. No death that could be attributed to side effects was detected. Thus, the Hypertension Detection and Follow-up Program data, which have previously demonstrated the beneficial effects of antihypertensive therapy, confirm the relative safety of such therapy.

Perceived symptoms and health-related quality of life reported by uncomplicated hypertensive patients compared to normal controls

“…Studies have shown no difference in symptoms between hypertensive and non-hypertensive patients, 24,25 whereas others have reported more symptoms and impaired well-being compared with normotensive control patients. [2][3][4][5][6][7] The findings of the present study regarding the differences in HQL between the hypertensive patients and the normal controls is consistent with previous populationbased studies. 2,[26][27][28][29][30] These studies, however, did not simultaneously measure disease-specific symptoms and HQL.…”

“…1 Although hypertension is thought to be asymptomatic, cognitive changes, mood alterations, and general symptoms such as dizziness and head-ache attributable to hypertension have been described. [2][3][4][5][6][7] Some symptoms are unique to antihypertensive medications, but overlap with symptoms described or attributed to the disease of hypertension as well as the general symptoms seen in a primary care population.…”

Relationship between blood pressure and depression in the elderly. The Three-City Study

“…Our study did not address this issue directly, but we performed analyses using the variable 'treatment or hospitalization for a nontraumatic serious illness within 2 years preceding the study entry' which was not statistically significantly associated neither with depression (x 2 0. 26 Another possible explanation of lower BP in depressive individuals compared with nondepressive ones could be the psychotropic effect of antihypertensive drugs [44][45][46] or the BP-lowering effect of some psychotropic agents. However, analyses stratified on these variables showed a consistent inverse association between depression and BP in all strata.…”

Nasal obstruction as a drug side effect

“…Side effects of angiotensinconverting enzyme inhibitors include chronic cough, urticaria, and rhinitis. Antihypertensives that block autonomic preganglionic nicotinic receptors, a-1 adrenergic receptor antagonists (doxazosin, silodosin, prazosin, tamsulosin, alfuzosin, terazosin), a-2 adrenergic receptor antagonists (mianserin) and some b-adrenergic receptor antagonists (carvedilol) have all been associated with nasal obstruction [Settipane and Charnock, 2007;Curb et al 1988]. Methyldopa is an alpha-adrenergic agonist psychoactive drug used as a sympatholytic or antihypertensive.…”

“…At doses of less than 0.2 mg/ day, reserpine has few side effects, the most common of which is nasal congestion [Curb et al 1988]. Guanethidine is an antihypertensive drug that reduces the release of catecholamines, such as noradrenaline.…”