A randomized controlled trial of the effects of three antihypertensive agents on blood pressure control and quality of life in older women

William B. Applegate, Harry L. Phillips, Harold Schnaper, Alexander M Shepherd, Douglas Schocken, Judith Challop Luhr, Gary C. Koch, Glen D. Park

Research output: Contribution to journalArticle

106 Citations (Scopus)

Abstract

We conducted a multicenter, randomized, double-blind, parallel group trial to compare the impact of titrated doses of atenolol (50 to 100 mg once a day), enalapril (5 to 20 mg once a day), and diltiazem (sustained release) (60 to 180 mg twice a day) on blood pressure and quality of life in older hypertensive women. Two hundred forty-two patients were randomized. Dose titration was completed by week 4 after randomization, and the maintenance phase was completed at week 16. Diltiazem (sustained release) demonstrated greater diastolic blood pressure lowering at both weeks 8 and 16 by an intent-to-treat analysis. At week 16, diltiazem changed diastolic blood pressure -13.7±0.7 mm Hg compared with -10.8±1.1 mm Hg for atenolol, and -10.5±0.9 mm Hg for enalapril. Diltiazem also demonstrated greater lowering of systolic blood pressure at week 8, but these differences in systolic blood pressure had decreased by week 16. More patients were classified as treatment failures during the 16 weeks of the trial for atenolol (15%) than for diltiazem (2.5%), while the treatment failure rate was intermediate with enalapril (8%). Total rates of adverse events were equivalent across the three treatment arms. There were few significant differences in the impact of the three treatments on mean scores of quality-of-life measures at week 16. There was a trend for atenolol to have somewhat worse quality-of-life scores, but none of these differences were statistically significant. In conclusion, all three treatment regimens were effective in lowering diastolic blood pressure without significant differences in rates of adverse events or deleterious effects on quality of life.

Original languageEnglish (US)
Pages (from-to)1817-1823
Number of pages7
JournalArchives of Internal Medicine
Volume151
Issue number9
StatePublished - Sep 1991

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Antihypertensive Agents
Randomized Controlled Trials
Quality of Life
Blood Pressure
Diltiazem
Atenolol
Enalapril
Treatment Failure
Random Allocation
Therapeutics
Maintenance

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Applegate, W. B., Phillips, H. L., Schnaper, H., Shepherd, A. M., Schocken, D., Luhr, J. C., ... Park, G. D. (1991). A randomized controlled trial of the effects of three antihypertensive agents on blood pressure control and quality of life in older women. Archives of Internal Medicine, 151(9), 1817-1823.

A randomized controlled trial of the effects of three antihypertensive agents on blood pressure control and quality of life in older women. / Applegate, William B.; Phillips, Harry L.; Schnaper, Harold; Shepherd, Alexander M; Schocken, Douglas; Luhr, Judith Challop; Koch, Gary C.; Park, Glen D.

In: Archives of Internal Medicine, Vol. 151, No. 9, 09.1991, p. 1817-1823.

Research output: Contribution to journalArticle

Applegate, WB, Phillips, HL, Schnaper, H, Shepherd, AM, Schocken, D, Luhr, JC, Koch, GC & Park, GD 1991, 'A randomized controlled trial of the effects of three antihypertensive agents on blood pressure control and quality of life in older women', Archives of Internal Medicine, vol. 151, no. 9, pp. 1817-1823.
Applegate, William B. ; Phillips, Harry L. ; Schnaper, Harold ; Shepherd, Alexander M ; Schocken, Douglas ; Luhr, Judith Challop ; Koch, Gary C. ; Park, Glen D. / A randomized controlled trial of the effects of three antihypertensive agents on blood pressure control and quality of life in older women. In: Archives of Internal Medicine. 1991 ; Vol. 151, No. 9. pp. 1817-1823.
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