Bisoprolol and nifedipine retard in elderly hypertensive patients: effect on quality of life

Abstract

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 р90 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

Influence of losartan and atenolol on memory function in very elderly hypertensive patients

“…[49][50][51] Unlike losartan, atenolol treatment did not significantly affect cognitive performance, which is in agreement with some previous observations showing no improvement, but also no deterioration in cognitive function of hypertensive patients treated with beta-blockers. [28][29][30][31][32] The difference between losartan and atenolol in their effects on cognitive function did not depend on their antihypertensive effect, since the BP reduction was similar with the two drugs.…”

“…Centrally acting sympathetic nervous system blocking agents, such as methyldopa and lipophilic beta-blockers like propranolol, have been reported to interfere negatively with memory and cognitive function, [26][27] although other studies have shown no significant adverse effect of beta-blockers including propranolol on cognitive performances. [28][29][30][31][32] Contrasting results have also been reported with diuretics 16,28,30 and calcium antagonists. 17,29,[32][33][34] Only antihypertensive drugs that interfere with the renin-angiotensin system seem to be effective in preventing cognitive decline and even improving cognitive function in hypertensive patients.…”

“…[28][29][30][31][32] Contrasting results have also been reported with diuretics 16,28,30 and calcium antagonists. 17,29,[32][33][34] Only antihypertensive drugs that interfere with the renin-angiotensin system seem to be effective in preventing cognitive decline and even improving cognitive function in hypertensive patients. Thus, in both experimental and clinical studies ACE inhibitors and the more recent Angiotensin II (AngII) antagonists have been shown to influence mental function positively, improving learning and memory.…”

Effect of Antihypertensive Medications on the Subjective Quality of Life in Previously Untreated Hypertensive Patients

“…with ACE inhibitors and ARBs 10,11 and others favored calcium channel blockers. 15 But in our study, when different classes of drugs were com pared with each other for improvement in quality of life, there was no significant difference between them. As for as the quality of life con cerned (Q1), score was highest for ACEI/ARB and score for satisfaction with health was highest for CCBs.…”

Lebensqualität und psychosoziale Faktoren unter antihypertensiver Therapie Ein Vergleich von Captopril und Quinapril bei geriatrischen Patienten

“…Neuere vergleichende Arbeiten zur Lebensqualität speziell bei geriatrischen Patienten erfolgten mit Betablockern, Calciumantagonisten, AT-1-Rezeptorantagonisten und Enalapril und konnten hier keine signifikante Überlegenheit einer antihypertensiven Einzelsubstanz nachweisen [7,9,21,27]. In den großen randomisierten Studien zur medikamentösen antihypertensiven Therapie bei älteren Patienten, wie SHEP, STOP, Syst-Eur und MRC, konnte der Nutzen der medikamentösen antihypertensiven Therapie in studies different antihypertensive agents exerted similar influences on QOL, Captopril was found to be superior to other antihypertensives in some trials.…”