Health-related quality of life during treatment of elderly patients with hypertension: Results from Study on COgnition and Prognosis in the Elderly (SCOPE)

Alessio Degl'Innocenti, D. Elmfeldt, A. Hofman, H. Lithell, B. Olofsson, I. Skoog, P. Trenkwalder, A. Zanchetti, I. Wiklund

Research output: Contribution to journalArticlepeer-review

Abstract

The Study on COgnition and Prognosis in the Elderly (SCOPE) was a multinational, randomised, double-blind study to assess the effects of candesartan 8-16 mg daily on cardiovascular events and cognitive function in elderly patients (aged 70-89 years) with mild to moderate hypertension. A total of 4937 patients were randomised to candesartan or placebo with other antihypertensive drugs (mostly diuretics, beta-blockers, and calcium antagonists) added as needed to control blood pressure. Only 16% of the patients in the control group received placebo alone. The mean follow-up was 3.7 years. The aim of this health-related quality of life (HRQL) substudy analysis was to investigate changes in HRQL during antihypertensive treatment, and possible differences in patients receiving candesartan-based or other antihypertensive treatment. Three validated HRQL instruments were used: the Psychological General Well-being (PGWB) Index, the Subjective Symptoms Assessment Profile (SSA-P), and the EuroQoL Health Utility Index (EuroQoL). The HRQL was generally good at baseline and well preserved during follow-up in the presence of substantial blood pressure reductions in both treatment groups. Several of the observed changes in score from baseline to last visit favoured candesartan-based compared to control treatment, particularly the changes in PGWB Anxiety (-0.5 vs -1.0, P = 0.01), PGWB Positive well-being (-0.8 vs -1.1, P = 0.04), SSA-P Cardiac symptoms (0.03 vs 0.10, P = 0.03), and EuroQoL Current health (-3.1 vs -5.3, P = 0.008). This favourable result may be related to the somewhat lower blood pressure associated with candesartan-based treatment. In conclusion, there should be no reason to withhold modern antihypertensive therapy in elderly patients due to concerns for a negative effect on HRQL.

Original languageEnglish
Pages (from-to)239-245
Number of pages7
JournalJournal of Human Hypertension
Volume18
Issue number4
DOIs
Publication statusPublished - Apr 2004

Keywords

  • Candesartan
  • Elderly
  • Health-related quality of life
  • Hypertension

ASJC Scopus subject areas

  • Internal Medicine

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