1. Home>
2. Specialties>
3. General Medicine>
4. Summary and Comment

CAPTOPRIL YIELDS BETTER QUALITY OF LIFE THAN ENALAPRIL.

Although antihypertensive therapy improves blood pressure and cardiovascular endpoints, it can also cause subtle deterioration in quality-of-life measures such as energy, cognition, and sexual activity. One previous study found quality of life to be better with captopril than with methyldopa and propranolol. To determine whether this benefit extends to other ACE inhibitors, this study randomized 379 men with mild-to-moderate hypertension to take either captopril (up to 50 mg twice daily) or enalapril (up to 20 mg daily) for 24 weeks.

Blood pressure control and major side effects during the study were identical in the two groups. However, scores for vitality, general health status, sleep disturbance, depression, and emotional control worsened with enalapril and improved with captopril. Patients with poorer quality- of-life scores before the study had stable or slightly improved scores with either drug. However, among patients with relatively good scores at baseline, scores worsened with enalapril and remained stable with captopril.

These surprising findings indicate that there can be important differences in the effect of therapy on quality of life, even within the same class of drugs. The data also support a growing body of research indicating that captopril has beneficial central-nervous-system effects.

— ALK

Published in Journal Watch General Medicine April 9, 1993

Citation(s):

Testa MA et al. Quality of life and antihypertensive therapy in men: a comparison of captopril with enalapril. N Engl J Med 1993 Apr 1 328 907-913.

• Original article (Subscription may be required)
• Medline abstract (Free)