Captopril therapy resulted in fewer withdrawals due to adverse effects (8% vs 20% for methyldopa and 13% for propranolol) and significantly improved general well-being (P<0.05 to <0.01).
RCT (n=626)
Double-blind
randomized
Yes
Do different antihypertensive agents (captopril, methyldopa, propranolol) have different effects on quality of life in men with mild to moderate hypertension?
Captopril provides a better quality of life profile, including improved general well-being and fewer side effects, compared to methyldopa and propranolol in men with mild to moderate hypertension.
Absolute Event Rate: 8% vs 20%
We conducted a multicenter randomized double-blind clinical trial among 626 men with mild to moderate hypertension to determine the effects of captopril, methyldopa, and propranolol on their quality of life. Hydrochlorothiazide was added if needed to control blood pressure. After a 24-week treatment period, all three groups had similar blood-pressure control, although fewer patients taking propranolol required hydrochlorothiazide. Patients taking captopril alone or in combination with a diuretic were least likely to withdraw from treatment because of adverse effects (8 percent vs. 20 percent for methyldopa and 13 percent for propranolol). The treatment groups were similar in scores for sleep dysfunction, visual memory, and social participation. However, patients taking captopril, as compared with patients taking methyldopa, scored significantly higher (P less than 0.05 to less than 0.01) on measures of general well-being, had fewer side effects, and had better scores for work performance, visual-motor functioning, and measures of life satisfaction. Patients taking propranolol also reported better work performance than patients taking methyldopa. Patients taking captopril reported fewer side effects and less sexual dysfunction than those taking propranolol and had greater improvement (P less than 0.05 to less than 0.01) on measures of general well-being. Our findings show that antihypertensive agents have different effects on the quality of life and that these can be meaningfully assessed with available psychosocial measures.
Croog et al. (1986) conducted an RCT in mild to moderate hypertension (n=626). captopril vs. methyldopa and propranolol was evaluated on withdrawal from treatment because of adverse effects. Captopril therapy resulted in fewer withdrawals due to adverse effects (8% vs 20% for methyldopa and 13% for propranolol) and significantly improved general well-being (P<0.05 to <0.01).