Skip to main content
SpringerLink
Log in

Quality of Life Comparison Between Bisoprolol and Nifedipine Retard in Hypertension

  • Published:
Cardiovascular Drugs and Therapy Aims and scope Submit manuscript

Abstract

Quality of life with the selective beta1-blocker bisoprolol and the calcium channel blocker nifedipine as a retard formulation was compared in patients with essential hypertension. A multicenter randomized, double-blind, two-way, crossover study design was used. After a placebo run-in period (4–6 weeks), during which all antihypertensive therapy was withdrawn, 82 patients were randomized. During the active treatment periods (8 weeks each), patients received either bisoprolol once daily or nifedipine retard twice daily, using the double-dummy technique. A washout period (4–6 weeks) separated the treatment periods. Data at baseline (at randomization) and at the end of each treatment period were compared. Seventy-five patients completed the study. Blood pressure (168 ± 2/103 ± 1 mmHg) decreased (p > 0.001) similarly with bisoprolol (153 ± 2/90 ± 1 mmHg) and nifedipine (154 ± 2/90 ± 1 mmHg). Compared with baseline values, none of the quality of life variables investigated changed during bisoprolol or nifedipine retard use. Neither in the intention-to-treat nor the efficacy analysis were differences between bisoprolol and nifedipine found in quality of life variables, such as the Health Status Index, somatic symptoms, anxiety, depression, total psychiatric morbidity, cognitive symptoms, and hostility score. Only in the efficacy analysis did Health Status Index tend to be better (p = 0.055) during nifedipine intake when compared with bisoprolol. This trend was not present in the intention-to-treat analysis. The number of dropouts during bisoprolol (n = 2) and nifedipine (n = 3) treatment, and the number of patients reporting side effects (21% and 16%, respectively) did not differ (p = 0.64) between both treatments. It can be concluded that at equipotent antihypertensive dosages, an 8-week treatment period with the selective beta1-blocker bisoprolol or the calcium antagonist nifedipine as a retard formulation does not result in any difference in quality of life variables. It is not clear whether the trend of Health Status Index to become better during nifedipine intake, which was only found in the efficacy analysis and not in the intention-to-treat analysis, is of clinical relevance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Guidelines Sub-Commitee. 1993 Guidelines for the management of mild hypertension: Memorandum from a World Health Organization/International Society of hypertension meeting. J Hypertens 1993;11:905–918.

    Google Scholar 

  2. McDonald LA, Sackett DL, Haynes RB, Taylor W. Hypertension: The effects of labelling on behaviour. Quality of life and cardiovascular care 1985;1:129–139.

    Google Scholar 

  3. Wenger NK. Quality of life issues in hypertension: Consequences of diagnosis and considerations in management. Am Heart J 1988;116:628–632.

    Google Scholar 

  4. Stumpe KO. Antihypertensive therapy: New strategies beyond blood pressure control. J Cardiovasc Pharmacol 1992;20(Suppl 6):S1–S4.

    Google Scholar 

  5. Bittar N. Maintaining long-term control of blood pressure: The role of improved compliance. Clin Cardiol 1995;18(Suppl 3):12–16.

    Google Scholar 

  6. Hjemdahl P, Wiklund IK. Quality of life on antihypertensive drug therapy: Scientific end-point or marketing exercise? J Hypertens 1992;10:1437–1446.

    Google Scholar 

  7. Testa MA, Simonson DC. Assessment of quality-of-life outcomes. N Engl J Med 1996;334:835–840.

    Google Scholar 

  8. Croog SH, Levine S, Testa MA, et al. The effects of antihypertensive therapy on the quality of life. N Engl J Med 1986;314:1657–1664.

    Google Scholar 

  9. Steiner SS, Friedhoff AJ, Wilson BL, Wecker JR, Santo JP. Antihypertensive therapy and quality of life: a comparison of atenolol, captopril, enalapril and propranolol. J Hum Hypertens 1990;4:217–225.

    Google Scholar 

  10. Fletcher AE, Bulpitt CJ, Chase DM, et al. Quality of life with three antihypertensive treatments: cilazapril, atenolol, nifedipine. Hypertension 1992;19:499–507.

    Google Scholar 

  11. Fletcher AE, Bulpitt CJ, Hawkins CM, et al. Quality of life on antihypertensive therapy: A randomized double-blind controlled trial of captopril and atenolol. J Hypertens 1990;8:463–466.

    Google Scholar 

  12. Beto JA, Bansal VK. Quality of life in treatment of hypertension. A metaanalysis of clinical trials. Am J Hypertens 1992;5:125–133.

    Google Scholar 

  13. Breed JGS, Ciampricotti R, Tromp GP, Valster FA, Lageweg E, Van Bortel LMAB. Quality of life perception during antihypertensive treatment: A comparative study of bisoprolol and enalapril. J Cardiovasc Pharmacol 1992;20:750–755.

    Google Scholar 

  14. Blumenthal JA, Ekelund L-G, Emery CF. Quality of life among hypertensive patients with a diuretic background who are taking atenolol and enalapril. Clin Pharmacol Ther 1990;48:447–454.

    Google Scholar 

  15. Palmer AJ, Fletcher AE, Rudge PJ, Andrews CD, Callaghan TS, Bulpitt CJ. Quality of life in hypertensives treated with atenolol or captopril: A double-blind crossover trial. J Hypertens 1992;10:1409–1416.

    Google Scholar 

  16. Cruikshank JM. Beta blockers and quality of life. Br J Clin Pract 1992;46:34–38.

    Google Scholar 

  17. Os I, Bratland B, Dahløf B, Gisholt K, Syvertsen J, Tretli S. Lisinopril or nifedipine in essential hypertension? A Norwegian multicenter study on efficacy, tolerability and quality of life in 828 patients. J Hypertens 1991;9:1097–1104.

    Google Scholar 

  18. Boissel JP, Collet JP, Lion L, et al. A randomized comparison of the effect of four antihypertensive monotherapies on the subjective quality of life in previously untreated asymptomatic patients: Field trial in general practice. J Hypertens 1995;13:1059–1067.

    Google Scholar 

  19. Testa MA, Hollenberg NK, Anderson RB, Williams GH. Assessment of quality of life by patient and spouse during antihypertensive therapy with atenolol and nifedipine gastrointestinal therapeutic system. Am J Hypertens 1991;4:363–373.

    Google Scholar 

  20. Fletcher AE, Chester PC, Hawkins CMA, Latham AN, Pike LA, Bulpitt CJ. The effects of verapamil and propranolol on quality of life in hypertension. J Hum Hypertens 1989;3:125–130.

    Google Scholar 

  21. Palmer A, Fletcher A, Hamilton G, Muriss S, Bulpitt C. A comparison of verapamil and nifedipine on quality of life. Br J Clin Pharmacol 1990;30:365–70.

    Google Scholar 

  22. Fletcher A, Bulpitt C. Quality of life in treatment of hypertension. The effect of calcium antagonists. Drugs 1992;44(Suppl 1):135–40.

    Google Scholar 

  23. Krämer B, Balser J, Stubbig K, Krämer G, Kübler W. Comparison of bisoprolol with other β-adrenoceptor blocking drugs. J Cardiovasc Pharmacol 1986;8(Suppl 11):S46–S57.

    Google Scholar 

  24. Bulpitt CJ, Fletcher AE. The measurement of quality of life in hypertensive patients: A practical approach. Br J Clin Pharmacol 1990;30:353–364.

    Google Scholar 

  25. Koch GG. The use of non-parametric methods in the statistical analysis of the two-period change-over design. Biometrics 1972;28:577–584.

    Google Scholar 

  26. Gillings D, Koch G. The application of the principle of intention-to-treat to the analysis of clinical trials. Drug Inform J 1991;25:411–424.

    Google Scholar 

  27. Jern S, Zanchetti A. The issue of quality of life in antihypertensive therapy. J Hum Hypertens 1993;7(Suppl 1):S46–S49.

    Google Scholar 

  28. McCarthy ST, McCarthy GL, John SM, Gould SE. A placebo-controlled cross-over study of ketanserin in elderly hypertensive patients. Cardiovasc Drugs Ther 1990;4:115–117.

    Google Scholar 

  29. Van Bortel LMAB, Breed JGS, Joosten J, Kragten JA, Lustermans FAT, Mooij JMV. Nebivolol in hypertension: A double-blind placebo-controlled multicenter study assessing its antihypertensive efficacy and impact on quality of life. J Cardiovasc Pharmacol 1993;21:856–862.

    Google Scholar 

  30. Neaton JD, Grimm RH, Prineas RJ, et al. Treatment of mild hypertension study. Final results. JAMA 1993;270:713–724.

    Google Scholar 

  31. Avorn J, Everitt DE, Weiss S. Increased anti-depressant use in patients prescribed beta-blockers. JAMA 1986;255:357–360.

    Google Scholar 

  32. Dahlöf C, Dimenäs E, Kendall M, Wilklund I. Quality of life in cardiovascular diseases. Emphasis on β-blocker treatment. Circulation 1991;84(Suppl VI):VI108–VI118.

    Google Scholar 

  33. Van Bortel LMAB, Ament AJHA. Selective versus nonselective β-adrenoceptor antagonists in hypertension. Pharmacoeconomics 1995;8:513–523.

    Google Scholar 

  34. Westerlund A. Central nervous system side-effects with hydrophilic and lipophilic beta-blockers. Eur J Clin Pharmacol 1985(Suppl 28):73–76.

    Google Scholar 

  35. Kleinbloesem CH, van Brummelen P, Danhof M, Faber H, Urquhart J, Breimer DD. Rate of increase in the plasma concentration of nifedipine as a major determinant of its hemodynamic effects in humans. Clin Pharmacol Ther 1987;41:26–30.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pharmacology, Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands

    Jan N.J.M. de Hoon, Floris H.M. Vanmolkot & Luc M.A.B. Van Bortel

  2. Medical Department, E. Merck, Amsterdam, The Netherlands

    Louis L.M. van de Ven

Authors
  1. Jan N.J.M. de Hoon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Floris H.M. Vanmolkot
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Louis L.M. van de Ven
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Luc M.A.B. Van Bortel
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

de Hoon, J.N., Vanmolkot, F.H., van de Ven, L.L. et al. Quality of Life Comparison Between Bisoprolol and Nifedipine Retard in Hypertension. Cardiovasc Drugs Ther 11, 465–470 (1997). https://doi.org/10.1023/A:1007701606758

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1007701606758

Search

Navigation