Antihypertensive treatment using an angiotensin receptor blocker and a thiazide diuretic improves patients’ quality of life: The Saga Challenge Antihypertensive Study (S-CATS)

Abstract

The aim of the Saga Challenge Antihypertensive Study (S-CATS), a single-arm, prospective and multi-center trial, was to evaluate the effectiveness of combined antihypertensive treatment with losartan and hydrochlorothiazide (HCTZ). Enrolled in the study were a total of 161 patients with hypertension, who in spite of treatment with an angiotensin receptor blocker (ARB) alone or an ARB and calcium channel blocker (CCB), had not been able to reach blood pressure control goals set by the Japanese Society of Hypertension Guidelines (JSH 2004). The ARBs were replaced with a combination pill containing losartan (50 mg) and HCTZ (12.5 mg), and this treatment was continued for 3 months. This change in therapy resulted in significant decreases in systolic (158 ± 14 to 137 ± 15 mm Hg, Po0.001) and diastolic (85 ± 11 to 76 ± 10 mm Hg, Po0.001) blood pressure and heart rate (73±3 to 72±3) during the study. The patients' quality of life (QOL) score, the EuroQol 5 dimensions (EQ-5D) and the visual analog scale (VAS) (n¼96; 70.0 (68.8-80.0) to 80.0 (70.0-90.0), Po0.01) all improved significantly. Another QOL score, the hypertension symptom score (HSS), which we originally developed for the S-CATS trial, decreased significantly (n¼93; 4.0 (1.0-9.0) to 2.0 (1.0-8.0), Po0.05). The Pittsburgh sleep quality index (PSQI), which is a psychometric assessment of subjective sleep quality, also decreased significantly (n¼45; 4.0 (2.0-7.0) to 3.0 (2.0-5.0), Po0.05). There was a significant correlation between a change in HSS (baseline value À3-months value) and a decrease in systolic blood pressure (n¼93; R¼0.241, Po0.05). These results suggest that an anti-hypertensive treatment combined with an ARB and a thiazide diuretic may improve patients' QOL, including sleep quality.

The impact of depression and cardiophobia on quality of life in patients with essential hypertension

“…* Our research design additionally minimizes the possible effect of other confounding factors as implemented medication. 49,50 Nevertheless, it could be useful to explore our hypothesis in multiple time points to establish more solid evidence.…”

Questionnaire Survey From the Viewpoint of Concordance in Patient and Physician Satisfaction Concerning Hypertensive Treatment in Elderly Patients ― Patients Voice Study ―

“…Advance Publication by-J-STAGE ies of combination drugs for HT showed improved adherence and patient QOL. 19, 20 Chen et al reported that the incidence of AEs ranged from 7.0% to 9.6% in patients receiving antihypertensive drugs, and that patients who had not experienced AEs had higher satisfaction. 21 In the present study, there were relatively low incidence rates for AEs (4.7%) and ADRs (2.4%).…”

Effects of Hydrochlorothiazide on Oxidative Stress and Pulse Pressure in Hypertensive Patients with Chronic Stroke: The EMINENT Study

“…Previous reports have also shown that combination treatment with losartan/HCTZ safely and steadily reduces the BP (19)(20)(21) and improves the quality of life in patients with uncontrolled hypertension (21). Furthermore, in patients with symptomatic internal carotid artery or middle cerebral artery steno-occlusive disease, this drug regimen also safely lowers the BP without worsening the cerebral hemodynamics (22).…”