Relationships between antihypertensive medications and selected aspects of work performance and absenteeism were explored in a multicentre, randomized, double-blind, clinical trial with 626 male hypertensive patients assigned to regimens of captopril, methyldopa or propranolol, either alone or supplemented as needed by a diuretic for blood pressure control. Patients previously on antihypertensive therapy did not differ from new patients in work absenteeism, both before and throughout the clinical trial. After a 24-week treatment period patients on captopril alone improved significantly over baseline in work-performance measures of mental acuity and job satisfaction-morale, while significant worsening in the methyldopa group and no change in the propranolol group occurred among patients given these drugs alone. When 24-week changes between groups not on diuretic were compared, significant differences in the measures appeared in favour of captopril. However, patients also taking a diuretic did not differ from baseline either within or between the three groups. Withdrawal from the trial because of lethargy and fatigue was significantly greater among patients on methyldopa and propranolol than among those receiving captopril. Absenteeism did not differ between the drug groups. The study shows that there are measurable differences in the impact of the antihypertensive drugs on aspects of work performance, and it underlines the importance of considering this factor in assigning patients to therapy.
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