Does lowering the blood pressure improve the mood? Quality-of-life results from the Hypertension Optimal Treatment (HOT) study

• Published in: Blood pressure Vol. 6; no. 6; p. 357
• Main Authors: Wiklund, I, Halling, K, Rydén-Bergsten, T, Fletcher, A
• Format: Journal Article
• Language: English
• Published: England 1997
• Subjects: Affect - drug effects; Aged; Aged, 80 and over; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Ankle - pathology; Ankle - physiopathology; Blood Pressure - drug effects; Blood Pressure - physiology; Calcium Channel Blockers - administration & dosage; Calcium Channel Blockers - therapeutic use; Cough - etiology; Cough - physiopathology; Data Interpretation, Statistical; Diastole; Dizziness - physiopathology; Edema - etiology; Edema - physiopathology; Felodipine - administration & dosage; Felodipine - therapeutic use; Female; Follow-Up Studies; Headache - physiopathology; Heart Diseases - physiopathology; Humans; Hypertension - drug therapy; Hypertension - prevention & control; Male; Middle Aged; Prospective Studies; Quality of Life; Surveys and Questionnaires
• ISSN: 0803-7051
• DOI: 10.3109/08037059709062095

Nine-hundred-and-twenty-two hypertensive patients were included in a substudy to the Hypertension Optimal Treatment study, which aimed to investigate the impact on quality of life of lowering the pressure and of intensified therapy. Seven-hundred-and-eighty-one patients completed both baseline and follow-up questionnaires (intention-to-treat population), while 610 patients were included in a per protocol analysis. Patients were randomized to three diastolic BP levels (DBPs), i.e. < or =90 mmHg, < or =85 mmHg and < or =80 mmHg. Two self-administered validated questionnaires, the Psychological General Well-Being index and the Subjective Symptoms Assessment Profile (SSA-P) were completed at baseline and after 6 months. The lower the DBP achieved, the greater the improvement in well-being (p < 0.05). The increase in well-being from baseline to 6 months was significant in target groups < or =80 mmHg (p < 0.01) and < or =85 mmHg (p < 0.05). The SSA-P domains, cardiac symptoms and dizziness improved in all groups but the sex life score deteriorated in the < or =80 and < or =85 mmHg groups in male patients. In all target groups, headaches were reduced (p < 0.001), while swollen ankles (p < 0.001) and dry cough in the < or =80 mmHg group (p < 0.001) increased. Although more intensive antihypertensive therapy is associated with a slight increase in subjective symptoms, it is nonetheless still associated with improvements in patients' well-being.