[What is the effect of lowering the arterial blood pressure on the quality of life? An auxiliary study to the HOT (Hypertension Optimal Treatment) trial].

Nine hundred and twenty-two hypertensive patients were included in a substudy to the hypertension optimal (HOT) study which aimed to investigate the impact on quality of life of lowering the pressure and of intensified therapy. Patients were randomised to three diastolic BPs (DBPs) levels, i.e. < or = 90 mmHg, < or = 85 mmHg and < or = 80 mmHg. Seven hundred and eighty one patients completed both baseline and follow-up questionnaires after 6 months (intention to treat, ITT, population), while 610 patients were included in a per protocol (PP) analysis. The lower the DBP achieved, the greater the improvement in well-being (p < 0.05). The increase in well-being from baseline to 6 months was significant in target groups < or = 80 mmHg (p < 0.01) and < or = 85 mmHg (p < 0.05). Cardiac symptoms and dizziness improved in all groups but the sex life score deteriorated in the < or = 80 and < or = 85 mmHg groups in male patients. Headaches were reduced in all groups (p < 0.001), while swollen ankles (p < 0.001), and dry cough in the < or = 80 mmHg group (p < 0.001) increased. Despite a slight increase in subjective symptoms, more intensive antihypertensive therapy was still associated with improvements in patients' well-being.