1. Impact of Amlodipine and Enalapril on Quality of Life in Patients with Essential Hypertension

Abstract

Background: The aim of the study was to analyse the effect of amlodipine and enalapril in monotherapy of primary arterial hypertension on the quality of life.

Material and methods: The study population consisted of 176 patients, 79 men and 97 women, aged from 19 to 75 years (maen age 50,4 ± 12,8) with mild to moderate essential hypertension. The study was a multicenter, prospective, randomised, double blind trial conducted in parallel groups. After 2 weeks of placebo the patients were randomised to amlodipine 2,5 mg/daily or enalapril 5 mg/daily. In case of inadequate control of blood pressure the doses were increased up to 10 mg (amlodipine) and 20 mg (enalapril) daily. After adjustment of dose treatment was continued for 8 weeks. Amlodipine was used by 87 patients (46 men and 41 women), whereas enalapril in 89 patients (33 men and 56 women). The quality of life was measured twice: after the wash-out period on placebo and after the active treatment using standardised questionnaires: the Psychological General Well-Being Index (PGWB) and the Health Status Index (HSI).

Results: After 8 weeks blood pressure and heart rate were similar in both groups. Blood pressure was normalised (BP < 140/90 mm Hg) in 72,4% of amlodipine and in 67,4% of enalapril users (NS). As compared with baseline the general quality of life (PGWB) improved after amlodipine (p < 0,01), especially in patients > 50 years of age. Improved HRQoL among amlodipine users was associated with decreased anxiety, and depresive mood, better well-being and vitality. Significantly improved general HSI index (symptoms associated with hypertension) was observed in younger patients (< 50 years of age) treated with amlodipine (p < 0,05). Amlodipine had a better effect on general quality of life in the PGWB test (net effect) than enalapril (+8,3% vs. 3,0%, p < 0,05).

Conclusions: In conclusion, the general quality of life was significantly more improved in patients on amlodipine than enalapril with a similar hypotensive efficacy. Furthermore the improved general quality of life after amlodipine was more pronounced in patients over 50 years of age. Amlodipine and enalapril had a similar effect on reducing the subjective symptoms associated with arterial hypertension