Effect of hydrochlorothiazide, enalapril, and propranolol on quality of life and cognitive and motor function in hypertensive patients
McCorvey, E.; Wright, J.T.; Culbert, J.P.; McKenney, J.M.; Proctor, J.D.; Annett, M.P.
Clinical Pharmacy 12(4): 300-305
1993
ISSN/ISBN: 0278-2677 PMID: 8458181 Document Number: 415248
The effect of hydrochlorothiazide, propranolol, and enalapril on cognitive and motor function and quality of life (QOL) in hypertensive patients was studied. Patients gtoreq 55 years of age with asymptomatic essential hypertension were included in a randomized, double-blind, placebo-controlled, crossover study. Subjects discontinued their previous antihypertensive agents and started hydrochlorothiazide 25 mg, extended-release propranolol hydrochloride 120 mg, enalapril maleate 10 mg, or placebo. One capsule was taken for three days and then the dosage was doubled for the remainder of a four-week period. Subsequent crossover treatments were begun without a washout period. In each treatment phase, a battery of psychometric tests was used to assess cognitive and motor function and quality of life; all tests but one were self-administered via computer terminal. Pulse rate and blood pressure were recorded, and compliance was monitored by capsule count. Sixteen of 30 patients interviewed completed the trials; one additional patient was evaluated after receiving all treatments except hydrochlorothiazide. Mean +- S.D. age of the subjects was 66 +- 6.1 years; 10 were black and 7 white; 9 were men. Except for the hydrochlorothiazide group, blood pressure in the active treatment groups did not differ significantly from placebo; hydrochlorothiazide significantly reduced systolic but not diastolic blood pressure compared with placebo. Compared with placebo, hydrochlorothiazide was associated with a fewer incorrect responses in a test of complex reaction time and with greater discriminant reaction time response rates; otherwise, no difference between groups was noted in cognitive or motor performance. There were no significant differences between active treatments and placebo on individual QOL measures. However, aggregated scores indicated that QOL may be worse with propranolol than with enalapril because of effects on sleep and energy. Cognitive and motor function was not impaired by the antihypertensive drugs used in this study. QOL was also not affected by antihypertensive therapy with hydrochlorothiazide or enalapril.