Key Points
- Determine the impact of antihypertensive drug therapy on patient quality of life across published randomized clinical trials.
- Conducted a systematic literature search (1970–1990) identifying 9 blinded, randomized clinical trials across 27 population groups (n = 1620) assessing 14 medications from 6 pharmacological classes.
- Evaluated five quality-of-life domains (sexual function, sleep, psychomotor function, general well-being, and mood) using self-reports, interviewer assessments, standardized cognitive tests, or sleep lab measures.
- Active drug treatment demonstrated small positive effect sizes for sleep (d = 0.106), psychomotor function (d = 0.283), general well-being (d = 0.139), and mood (d = 0.167).
- No measurable treatment effect was observed for sexual function (d = -0.030, based on 95% CI), and no overall adverse quality-of-life effects were identified across drug classes.
- Angiotensin-converting enzyme inhibitors and beta-blockers showed more frequent positive effects across all evaluated domains compared to other drug classes.
Structured PICO
Does antihypertensive drug therapy improve quality of life in patients with hypertension?
PPopulation1,620 patients with hypertension from 9 published trials (27 population groups)
IInterventionAntihypertensive drug therapy (14 drugs from 6 pharmacological groups, including ACE inhibitors, beta-blockers, calcium-channel blockers, and diuretics)
CComparatorBaseline (placebo or no treatment) with patients as their own control
OOutcomeQuality of life (QL) constructs: sexual function, sleep, psychomotor, general well-being, and moodpatient reported
Antihypertensive drug therapy provides small improvements in sleep, psychomotor function, general well-being, and mood, with no negative effects on overall quality of life.
Limitations
- Narrower demographics and smaller sample sizes may have biased similar positive effects in calcium-channel blockers and diuretics