Copyright © 1993 by the European Society of Cardiology.
© 1993 The European Society of Cardiology
Elderly hypertensives and quality of life: some methodological considerations
Maison des Truites Gilly, Switzerland
Received 24 October 1991; revised 13 July 1992; .
Correspondence: Mary Ellen Kitler. Ph D., F.C.P. Maison des Truites, CH-1182 Gilly, Switzerland
Abstract
Management of mild hypertension in the elderly aims at symptom relief and a change in the natural history of hypertension. This is often difficult, since mild hypertension is generally symptomless but drug therapy may have serious quality of life sequelae. Therefore, aspects of patient I well-being, including physical, emotional, and social status, should become important treatment considerations, which can be achieved by a patient-specific approach. Quality of life claims for specific drugs appeal to the desire of the prescriber to use the best drug in real-life situations. Physicians generally are guided in their selection of a particular drug for a particular patient by results of clinical trials. This is still difficult to achieve with quality of life studies pertaining to drug management of mild hypertension in the elderly. Few studies have been done, and some do not yield clear results. One needs to study carefully the duration of the trial, the validation of the instruments used, the approach to confounding factors such as inclusion and stratification of elderly by decade of life, inclusion of females in requisite numbers and prior symptoms of patients who, more likely than not, suffer from a host of intercurrent diseases and have been placed on multiple drugs.
Key Words: Elderly • quality of life • hypertension • anti-hypertensive agents • coronary disease • clinical trials • clinical trial methodology • chronic disease • research design • clinical protocols • cardiology