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Titolo:
RELATIONSHIPS OF QUALITY-OF-LIFE MEASURES TO LONG-TERM LIFE-STYLE ANDDRUG-TREATMENT IN THE TREATMENT OF MILD HYPERTENSION STUDY
Autore:
GRIMM RH; GRANDITS GA; CUTLER JA; STEWART AL; MCDONALD RH; SVENDSEN K; PRINEAS RJ; LIEBSON PR;
Indirizzi:
SHAPIRO CTR,914 S 8TH ST,D2 MINNEAPOLIS MN 55404 UNIV MINNESOTA,SCH MED,DEPT MED,DIV CARDIOVASC DIS MINNEAPOLIS MN 55455 UNIV MINNESOTA,SCH PUBL HLTH,DIV BIOSTAT MINNEAPOLIS MN 55455 NHLBI,DIV EPIDEMIOL & CLIN APPLICAT,NIH BETHESDA MD 20892 UNIV CALIF SAN FRANCISCO,SCH NURSING,INST HLTH & AGING SAN FRANCISCO CA 94143 UNIV PITTSBURGH,SCH MED,DEPT MED PITTSBURGH PA 00000 UNIV MIAMI,SCH MED,DEPT EPIDEMIOL & PUBL HLTH MIAMI FL 00000 RUSH MED COLL,DEPT MED,CARDIOL SECT CHICAGO IL 60612 RUSH MED COLL,DEPT PREVENT MED CHICAGO IL 60612
Titolo Testata:
Archives of internal medicine
fascicolo: 6, volume: 157, anno: 1997,
pagine: 638 - 648
SICI:
0003-9926(1997)157:6<638:ROQMTL>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
RANDOMIZED CONTROLLED TRIAL; BLOOD-PRESSURE; ANTIHYPERTENSIVE THERAPY; DEPRESSION; SMOKING;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
27
Recensione:
Indirizzi per estratti:
Citazione:
R.H. Grimm et al., "RELATIONSHIPS OF QUALITY-OF-LIFE MEASURES TO LONG-TERM LIFE-STYLE ANDDRUG-TREATMENT IN THE TREATMENT OF MILD HYPERTENSION STUDY", Archives of internal medicine, 157(6), 1997, pp. 638-648

Abstract

Objectives: To compare 5 antihypertensive drugs and placebo for changes in quality of life (QL). To assess the relationship of lifestyle factors and change in lifestyle factors to QL in participants with stageI diastolic hypertension. Methods: The Treatment of Mild HypertensionStudy (TOMHS) was a randomized, double-blind, placebo-controlled clinical trial with minimum participant follow-up of 4 years. It was conducted at 4 hypertension screening and treatment academic centers in theUnited States. The cohort consisted of 902 men and women with hypertension, aged 45 to 69 years, with diastolic blood pressures less than 100 mm Hg. Informed consent was obtained from each participant after the nature of the procedures had been fully explained. Sustained nutritional-hygienic intervention was administered to all participants to reduce weight, to reduce dietary sodium and alcohol intake, and to increase physical activity. Participants were randomized to take (1) acebutolol (n = 132); (2) amlodipine maleate (n = 131); (3) chlorthalidone (n= 126), (4) doxazosin mesylate (n = 134); (5) enalapril maleate (n = 135): or placebo (n = 234). Changes in 7 QL indexes were assessed based on a 35-item questionnaire: (1) general health; (2) energy or fatigue; (3) mental health; (4) general functioning; (5) satisfaction with physical abilities; (6) social functioning; and (7) social contacts. Results: At baseline, higher QL was associated with older age, more physical activity, lower obesity level, male gender, non-African American race, and higher educational level. Improvements in QL were observed in all randomized groups, including the placebo group during follow-up;greater improvements were observed in the acebutolol and chlorthalidone groups and were evident throughout follow-up. The amount of weight loss, increase in physical activity, and level of attained blood pressure control during follow-up were related to greater improvements in QL. Conclusions: In patients with stage I hypertension, antihypertensive treatment with any of 5 agents used in TOMHS does not impair QL. Thediuretic chlorthalidone and the cardioselective beta-blocker acebutolol appear to improve QL the most, Success with lifestyle changes affecting weight loss and increase in physical activity relate to greater improvements in QL and show that these interventions, in addition to contributing to blood pressure control, have positive effects on the general wellbeing of the individual.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/11/20 alle ore 06:59:15