Changes in the Quality of Life of Hypertensives after Replacing Short-acting Nifedipine with Amlodipine

Abstract

Background The purpose of the study was to evaluate the quality of life (QoL), tolerance and satisfaction with the therapy among hypertensive patients receiving amlodipine, which replaced nifedipine.

Material and methods The study population consisted of 230 patients (121 men and 109 women) receiving short-acting nifedipine (mean dose 30,1 mg daily) for at least 3 months in mono- or polytherapy, with SBP not exceeding 180 mm Hg and DBP 105 mm Hg. Nifedipine was replaced with amlodipine in a dose of 5 mg daily — the treatment was continued for 12 weeks. In those patients in whom DBP > 90 mm Hg and/or SBP > 160 mm Hg was found at 6 weeks, the dose of amlodipine was increased to 10 mg daily. The quality of life was evaluated twice: before and after amlodipine therapy using the Psychological General Well Being Index (PGWB). Additionally the patients evaluated tolerance and satisfaction with previous nifedipine and amlodipine therapy using a separate questionnaire.

Results The replacement of short-acting nifedipine with amlodipine resulted in blood pressure normalisation (BP < 140/90 mm Hg) in 61% of the patients (vs 19% on nifedipine) and a significant improvement of quality of life in 83% of patients. After 12-week amlodipine treatment DBP below 90 mm Hg was achieved in 92% of the patients (vs. 47% on nifedipine). SBP decrease was greater after amlodipine in women than in men. The total index of the PGWB improved significantly in both sexes (p < 0,01) after 12 weeks on amlodipine. The highest quality of life was observed in patients with the lowest BP after amlodipine and in those who all the time received amlodipine 5 mg daily. The responders ranked amlodipine tolerance significantly higher than nifedipine and they were satisfied more with amlodipine than during previous treatment with nifedipine.

Conclusion The replacement of short-acting nifedipine with amlodipine provides a better control of arterial BP and improves significantly the quality of life, irrespective of sex, age, duration and severity of hypertension as well as the number of hypotensive drugs administered.