Quality of life on antihypertensive therapy: a randomized double-blind controlled trial of captopril and atenolol

Fletcher, AE; Bulpitt, C J; Cm, Hawkins; Havinga, Tk; Tenberge, Bs; May, JF; Schuurman, F. H.; Vanderveur, E; Wesseling, H

doi:10.1097/00004872-199005000-00011

Cited by 70 publications

(33 citation statements)

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“…However, what was later found with the non-selective lipid soluble propranolol did not apply to all beta-blockers. The beta 1 selective atenolol was found to have a similar quality of life score to ACE inhibitors, 41 while the nonselective propranolol was found to have poorer global score, confirming the findings of Croog et al 40 Further studies confirm that atenolol was similar to captopril, 42 and Fletcher et al 43 in a large doubleblind, randomised parallel group study, observed that cilazapril and atenolol were similar in quality of life assessment, both superior to nifedipine. The highly beta 1 -selective bisoprolol has been reported to be similar to enalapril, 44 while a combination of low dose (6.25 mg) hydrochlorothiazide and bisoprolol was found to have a similar quality of life to amlodipine with a trend to be better than enalapril.…”

Section: Side Effects Quality Of Lifementioning

confidence: 53%

New approaches to the uses of beta blocking drugs in hypertension

Prichard

Graham

Cruickshank³

2000

J Hum Hypertens

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After a slow start, beta-blockers have become widely used as first-line agents in the treatment of hypertension, and recommended as such in recently published guidelines. There is evidence that the beta 1 -selective agents are more efficacious than non-selective blockers that inhibit both beta 1 and beta 2 receptors. Notwithstanding some earlier evidence to the contrary, it appears that beta 1 -selective drugs are equi-effective in young and elderly whites, younger, ie, under mid 60s, blacks. It is with the combination of age and being black that beta-blockers are usually less useful than some other groups of antihypertensive drugs, most notably calcium antagonists and diuretics. Primary prevention studies indicate beta-blockers reduce the incidence of cerebro-vascular disease and coronary heart disease in younger patients but they appear less effective than diuretics in the elderly. Beta-blockers are particularly indicated in patients who have experienced a myocar-

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Section: Side Effects Quality Of Lifementioning

confidence: 53%

New approaches to the uses of beta blocking drugs in hypertension

Prichard

Graham

Cruickshank³

2000

J Hum Hypertens

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“…Since participation in a clinical trial itself may result in better quality of life scores, comparison with baseline measurements might lead to incorrect conclusions and should therefore be interpreted with caution. 11,12,25,33 As no placebo group was included in the present study, absolute effects of the drugs on quality of life cannot be assessed. No difference in quality of life was found between bisoprolol and the ACE-inhibitor enalapril, 10,34 the calcium antagonists verapamil, 34 and nifedipine, 15 and the combined diuretic altizide/spironolactone.…”

Section: Discussionmentioning

confidence: 99%

Impact of antihypertensive treatment on quality of life: comparison between bisoprolol and bendrofluazide

et al. 1999

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“…Persistent dry cough is the most common side-effect within 4 weeks of starting treatment [5,6], and is of ACE inhibitors [1], and the most frequent reason characteristically dry, repetitive, occurs in bouts for stopping treatment [2, 3,4]. It [4].…”

Section: Introductionmentioning

confidence: 99%

“…However among those who persist with treatment most consider their cough to be moderate or severe, and in the majority it disturbs sleep and is a nuisance to others [4]. The incidence of ACE inhibitor cough in controlled studies using validated methods of ascertainment is about 20% [4,5,7]. The cough is persistent, with a prevalence of 16% after 2 years of treatment [4] in addition to the 6% of patients who had stopped treatment because of cough [4].…”

Section: Introductionmentioning

confidence: 99%

“…Treatments such as non-steroidal anti-inflammatory drugs [8,9], theophylline [10] or sodium cromoglycate [11] have not proved effective. Sex and smoking habit are the only factors clearly related to development of ACE inhibitor cough, with cough reported twice as often by women [1,2,5,12] and by non-smokers [12]. No clear relation has emerged between the dose of ACE inhibitor and development of cough [1,2], but the effect of adjusting the dose of ACE inhibitor in patients with cough to determine whether there is a dose-response relationship has not been examined formally.…”

Section: Introductionmentioning

confidence: 99%

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8 Effect of dose adjustment on enalapril-induced cough and the response to inhaled capsaicin

Yeo

Higgins

Foster

et al. 1994

Journal of Hypertension

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1 In nine hypertensive patients with enalapril-induced cough the effect of altering the dose of enalapril on subjective cough and the cough response to inhaled capsaicin was examined in a random single-blind balanced cross-over study. They received three doses of enalapril, each for 3 weeks; the dose at entry (mean 10 mg daily); double this dose (mean 20 mg daily); and half this dose (mean 5 mg daily). 2 The cough response to inhaled capsaicin was also measured in two control groups:hypertensive patients on long-term enalapril treatment with no cough (n = 18), and hypertensive patients taking nifedipine (n = 17). 3 In patients with enalapril-induced cough there were significant dose-responses for enalapril as regards severity of cough (P < 0.05) and night time waking by cough (P < 0.05), but not for frequency of cough. Although the cough was less severe (P < 0.02) and caused less night time waking (P < 0.03) on the lowest dose of enalapril (mean 5 mg daily) it did not disappear completely in any patient. 4 The sensitivity to inhaled capsaicin did not differ significantly on the three doses of enalapril. The relative potency of capsaicin on enalapril 20 mg compared with enalapril 5 mg was 1.0 (95% CI 0.4-2.2). The wide confidence limits indicate that an important dose-dependent shift in capsaicin sensitivity is not excluded. 5 The sensitivity to inhaled capsaicin differed significantly between patients with enalapril-induced cough and both control groups. The relative potency of capsaicin was 0.2 (95% CI 0.1-0.4, P < 0.001) in patients taking nifedipine, and 0.4 (95% CI 0.2-0.8, P < 0.005) in patients taking enalapril who had no cough, when compared with patients with enalapril-induced cough. 6 The dose-response for capsaicin was shifted significantly to the left in patients on enalapril who had no cough when compared with patients taking nifedipine (relative potency 0.5, 95% CI 0.3-1.0, P < 0.05). 7 In patients with enalapril-induced cough reducing the dose improves the severity of cough and night time waking, but this may be of limited value as the cough persisted to some degree in all patients. 8 The enhanced sensitivity to capsaicin in patients taking enalapril who had no cough suggests that ACE inhibitors may alter the cough reflex in all patients, with those who develop cough representing the extreme of this general shift. This hypothesis needs to be tested in a larger prospective study.

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Quality of life on antihypertensive therapy: a randomized double-blind controlled trial of captopril and atenolol

Cited by 70 publications

References 0 publications

New approaches to the uses of beta blocking drugs in hypertension

New approaches to the uses of beta blocking drugs in hypertension

Impact of antihypertensive treatment on quality of life: comparison between bisoprolol and bendrofluazide

8 Effect of dose adjustment on enalapril-induced cough and the response to inhaled capsaicin

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