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

Journal of Human Hypertension volume 18, pages 239–245 (2004)Cite this article

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.

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Acknowledgements

We thank all patients who participated in the study, all investigators and committee members, as well as all monitoring and coordinating staff at AstraZeneca. We also thank Jonas Carlsson for the statistical analysis. We are indebted to AstraZeneca for sponsoring the SCOPE study.

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Authors and Affiliations

  1. AstraZeneca R&D, Clinical Science, Mölndal, Sweden

    A Degl'Innocenti, D Elmfeldt, B Olofsson & I Wiklund

  2. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden

    D Elmfeldt & H Lithell

  3. Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands

    A Hofman

  4. Department of Psychiatry, Institute of Clinical Neuroscience, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden

    I Skoog

  5. Department of Internal Medicine, Starnberg Hospital, Munich University, Starnberg, Germany

    P Trenkwalder

  6. Centro di Fisiologia Clinica e Ipertensione, University of Milan, Ospedale Maggiore, Istituto Auxologico Italiano, Milano, Italy

    A Zanchetti

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  1. A Degl'Innocenti
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Correspondence to A Degl'Innocenti.

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Degl'Innocenti, A., Elmfeldt, D., Hofman, A. et al. Health-related quality of life during treatment of elderly patients with hypertension: results from the Study on COgnition and Prognosis in the Elderly (SCOPE). J Hum Hypertens 18, 239–245 (2004). https://doi.org/10.1038/sj.jhh.1001657

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  • DOI: https://doi.org/10.1038/sj.jhh.1001657

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