Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Six hundred and twenty-six male patients with mild to moderate hypertension were enrolled in a multicentre randomized double-blind clinical trial to determine the effect of methyldopa, captopril and propranolol on the quality of life of these patients. During the 6-month trial hydrochlorothiazide was added to the treatment programme of those patients whose blood pressure was not normalized. More individuals in the captopril group (33%) required hydrochlorothiazide than in the propranolol group (22%). As a group, those individuals who required a diuretic were heavier and had higher basal and end-of-study blood pressure than those individuals requiring only monotherapy. However, the basal quality-of-life indices were similar in the six treatment subgroups. The withdrawal rate from the study was twice as high for those patients treated with propranolol and methyldopa as for those treated with captopril, whether a diuretic was added or not. More individuals requiring a diuretic experienced sexual dysfunction and a substantial worsening of their general well-being and of physical symptom indices over the 24 weeks of the study (P less than 0.01), particularly in the captopril and propranolol treatment subgroups. In summary, the present results suggest that diuretic therapy may have a greater negative impact on the quality of life of hypertensive patients than captopril, propranolol or methyldopa alone.
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PMID:Impact of antihypertensive therapy on quality of life: effect of hydrochlorothiazide. 355 93

We examined the associations between unmedicated systolic and diastolic blood pressure (BP) levels and measures of quality of life (QOL). Women (N = 315) ranging in age from 60 to 80 with diagnoses of mild to moderate hypertension were removed from antihypertensive medications and placed on placebo medication in the context of a clinical drug trial. Unmedicated BP levels were measured at the QOL interview, which followed a 4- to 8-week placebo run-in period, and at the preceding visit 1 week earlier. Indices representing five QOL dimensions were obtained in the QOL interview. The QOL dimensions assessed were: 1) sense of general well-being; 2) cognitive functioning; 3) affective status; 4) physical health status; and 5) level and enjoyment of social activity. QOL indices were regressed on unmedicated systolic and diastolic BP levels and on duration of hypertension in separate models. Each regression model included age, education, cigarette smoking, alcohol intake, and body mass index as covariables. We found that unmedicated BP levels were inversely related to QOL measures of cognitive functioning and social activity level. Although duration of hypertension was not related to cognitive functioning or social activity level, duration was associated with indices representing other dimensions of QOL. Specifically, duration of hypertension was inversely related to sense of general well-being and positively related to measures of physical health status, i.e., physical symptom incidence and sleep dysfunction.
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PMID:Unmedicated blood pressure levels and quality of life in elderly hypertensive women. 808 72

Research on comorbidity across cancer symptoms, including pain, fatigue, and depression, could suggest if crossover effects from symptom-specific interventions are plausible. Secondary analyses were conducted on a survey of 268 cancer patients with recurrent disease from a northeastern U.S. city who were initiating palliative radiation for bone pain. Moderator regression analyses predicted variation in depressive affect that could be attributed to symptom clusters. Patients self-reported difficulty controlling each physical symptom over the past month on a Likert scale and depressive symptoms on a validated depression measure (Center for Epidemiologic Studies-Depression [CES-D]) over the past week on a four-category scale. An index of depressive affect was based on items of negative and positive affect from the CES-D. In predicting depressive affect, synergistic interactions of pain with fever, fatigue, and weight loss suggest separate pathways involving pain. A similar interaction with fever occurs when nausea was tested in place of pain. Further, the interaction between pain and fatigue is similar in form to the interaction between difficulty breathing and fatigue (when sleep is not a problem). Follow-up to the latter interaction reveals: 1) additional moderation by hypertension and palliative radiation to the hip/pelvis; and 2) a similar cluster not involving hypertension when appetite problems and weight loss were tested in place of fatigue. The significance and form of these interactions are remarkably consistent. Similar sickness mechanisms could be generating: 1) pain and nausea during fever; 2) pain and fatigue during weight loss; and 3) pain and breathing difficulty when fatigue is pronounced. Crossover effects from symptom-specific interventions appear promising.
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PMID:The relationship of cancer symptom clusters to depressive affect in the initial phase of palliative radiation. 1573 6