Effect of antihypertensives on sexual function and quality of life: the TAIM study

Article Abstract:

Patients with mild high blood pressure (hypertension) often have no symptoms (asymptomatic). As many antihypertensive drugs have recognized side effects, a common perception among physicians is that patients regard the treatment as worse than the disease. In recent years, studies of drugs and their side effects have included evaluations of effects on quality of life. A recent study, the Trial of Antihypertensive Interventions and Management (TAIM), was designed to assess the effects of various combinations of drug and diet therapies on blood pressure, cardiovascular risks and quality of life after six months of therapy. The drugs studied were chlorthalidone, atenolol, and a placebo; the diets were a usual diet, a low sodium, high potassium diet, and a weight-reducing regimen. Among the quality of life issues studied were sleep, depression, anxiety, fatigue, satisfaction with physical health, and sexual satisfaction. While there may have been some clinically relevant side effects, there were no statistically significant adverse effects attributed to either antihypertensive drug or the placebo. One exception was chlorthalidone, which caused problems with erection, orgasm, and sexual interest in men who maintained their usual diets. However, the patients on chlorthalidone and a weight-reducing diet had the least sexual dysfunction, as well as the greatest weight loss and blood pressure reduction. The weight-reducing diet seemed to enhance satisfaction with physical health, while the low sodium, low potassium diet caused sexual problems in men, and had more adverse effects on sleep and fatigue than did a usual diet. The weight-reducing diet enhanced the blood pressure reducing effect of both drugs, and reduced cardiovascular risks; the combinations of low sodium, low potassium diet and antihypertensive drug therapy did not. Thus, this study suggests that a weight-reducing diet can be a useful addition to drug therapy, as it seems to prevent problems with sexual function in asymptomatic male patients with mild hypertension. (Consumer Summary produced by Reliance Medical Information, Inc.)

Sexual disorders, Management, Complications and side effects, Quality of life, Antihypertensive drugs, Antihypertensive agents

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Pharmacologic and nutritional treatment of mild hypertension: changes in cardiovascular risk status

Article Abstract:

Drugs used to treat hypertension, abnormally high blood pressure, may actually increase the risk of developing cardiovascular disease, which affects the major blood vessels supplying the heart. Adverse effects of antihypertensive agents on cardiovascular risk factors may be particularly important in patients with less severe hypertension, because most deaths due to hypertension occur among people with moderate hypertension. The effects of diet and drug therapy for mild hypertension on cardiovascular risk factors were assessed in 692 patients with mild hypertension and whose weight was between 110 and 160 percent of ideal. Nine different therapy regimens were developed using combinations of the usual, low sodium-high potassium weight loss diets and the antihypertensive agents, chlorthalidone and atenolol, or else a placebo or substance with no known therapeutic effect. The cardiovascular risk associated with each of the nine different treatment combinations was evaluated after a period of six months. A decrease in blood pressure was associated with a reduction in cardiovascular risk in all treatment groups except that in which the usual diet was combined with chlorthalidone, which produced increased cholesterol levels. Antihypertensive agents combined with a weight loss diet were associated with the lowest risk of cardiovascular disease. The findings show that diet and antihypertensive agents have different effects on cardiovascular risk, and dietary therapy, particularly weight reduction, helped to reduce cardiovascular risk. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Coronary heart disease

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Prevention of heart failure by antihypertensive drug treatment in older persons with isolated systolic hypertension

Article Abstract:

A stepped-care antihypertensive drug regimen beginning with low-dose diuretics may lower the risk of heart failure in elderly patients with moderate hypertension. Researchers randomly assigned 4,736 such patients to take increasing doses of chlorthalidone or placebo or atenolol or placebo. Atenolol is given if the patient doesn't respond to chlorthalidone. Patients who took chlorthalidone or atenolol had half the risk of heart failure compared to those taking a placebo. Patients with a prior heart attack had only one-fifth the risk of heart failure compared to those taking a placebo.

Health aspects, Aged, Elderly, Evaluation, Prevention, Heart failure

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