The Impact of Rilmenidine on Quality of Life in Essential Hypertension

Abstract

Background The aim of the study was to evaluate the effect of rilmenidine on the quality of life of patients with mild to moderate primary arterial hypertension.
Material and methods The study group consisted of 87 patients, 51 men (mean age 35.6 ± 13.8 years) and 36 women (mean age 44.7 ± 11.6 years) with mild to moderate essential hypertension. The mean duration of hypertension was similar in men and women (6.1 vs 6.0 years). After two weeks of placebo therapy, when SBP was > 145 mm Hg and DBP > 95 mm Hg, rilmenidine in dose 1 mg/daily was given for 4 weeks. The quality of life was evaluated according to the Polish version of the Health Status Index (HSI), which was administered three times: before the study, after 2 weeks of placebo and at one month after rilmenidine therapy A total of 74 patients, 43 men and 31 women completed the study The men and the women did not differ with respect to the mean BMI (M = 27.1 ± 4.2 kg/m2, F = 27.9 ± 4.1 kg/m2). Alcohol consumption was five times more frequent in men (29.4% of regularly drinking men), and its amount in the study group ranged from 20 to 60 ml per week.
Results Blood pressure below 140/90 mm Hg after rilmenidine was observed in 69% of men and 76% of women. Rilmenidine ingestion was not associated with any side effects in all patients. The improvement of the HSI after placebo was found in 52.6% of the patients, and its deterioration in 14.1%. Further improvement of the quality of life after rilmenidine was observed in 59.5% of the patients, and its worsening in 9.5%. The quality of life of the remaining patients did not change. The rilmenidine-induced improvement of the quality of life in men was a result of decreased frequency and severity of headaches, decreased somnolence during the day and flushes, and increased sexual activity. In women the improvement was also associated with decreased frequency and severity of headaches, decreased somnolence during the day, fatigue and flushes, and moreover elimination of dry cough, rashes, swelling of the legs and nightmares. The deterioration in the quality of life in men and women was associated with the development of somnolence during the day, nocturia, more frequent headaches and - only in women -with reduced interest in sexual life. Conclusion Rilmenidine in monotherapy improves quality of life of men and women with arterial hypertension. Further studies are necessary to evaluate long-term effects of the agent on the quality of life, especially in the elderly.