Applying quality of life data in practice. Considerations for antihypertensive therapy

Quality of life issues have become increasingly important in tailoring antihypertensive therapy to individual patients. The application of quality of life data to the practice setting is frequently difficult, however. The effective use of this information requires an understanding of its definition and measurement, as well as of study methods. Quality of life findings may be specific to particular disease states, patient populations, and pharmacologic agents. The addition of hydrochlorothiazide to concurrent methyldopa, propranolol, or captopril therapy has been reported to reduce patients' overall sense of well-being. beta-Adrenergic blockers may exert either positive or negative effects on quality of life. Angiotensin-converting enzyme (ACE) inhibitors may have positive effects on quality of life; however, the cost of therapy is an important consideration. Information on calcium antagonists is limited. The findings of the Treatment of Mild Hypertension Study (TOMHS) may eventually provide comparative quality of life data on the four first-line antihypertensive therapies.