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Health-related quality of life is worse in individuals with hypertension under drug treatment: results of population-based study

Journal of Human Hypertension volume 26, pages 374–380 (2012)Cite this article

Abstract

Patients with hypertension usually report lower health-related quality of life (HRQoL), but it is unclear whether this is secondary to high blood pressure (BP) per se, drug treatment or awareness of disease. In a cross-sectional study using a multistage population-based sample, participants were interviewed and examined at home. Hypertension was defined by BP ⩾140/90 mm Hg or use of BP-lowering drugs. HRQoL was assessed through the Short-Form Health Survey (SF-12) and presented as the physical component summary (PCS), mental component summary (MCS) and the SF-12 eight-domain scale. In total, 1858 individuals were evaluated, being 60.1% women, aged 52.5±4.1 years old, and 39.9% men, aged 47.2±9.1 years old. Prevalence of hypertension was 34.2% (95% CI 31.5–36.9). The PCS scores for hypertensive and normotensive participants were 49.4 (CI 48.6–50.2) and 51.06 (CI 50.4–51.7) (P=0.01), respectively, and the MCS scores were 49.1 (CI 47.9–50.3) and 50.5 (CI 49.6–51.2) (P=0.06), respectively. Participants with hypertension and not using BP drugs had higher HRQoL scores (PCS 49.6; MCS 51.9) than those using BP drugs either with uncontrolled (PCS 45.3; MCS 49.4) or controlled BP (PCS 46.2; MCS 47.7; P<0.05). We concluded that individuals with hypertension have worse quality of life, particularly when their BP is controlled by drugs. This perception may lead to lower rates of adherence to treatment.

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References

  1. Kaplan NM, Victor RG . Kaplan's Clinical Hypertension, 10th edn. Lipincott Williams & Williams: Philadelphia, 2010.

    Google Scholar 

  2. Gill TM, Feinstein AR . A critical appraisal of the quality of quality-of-life measurements. JAMA 1994; 272: 619–626.

    Article  CAS  Google Scholar 

  3. Herschbach P . [Respecting subjective perception of the patient. The ‘quality of life’ concept changes medicine]. MMW Fortschr Med 1999; 141: 57.

    CAS  PubMed  Google Scholar 

  4. Moller-Leimkuhler AM, Dunkel R, Muller P . [Determinants of patient satisfaction: treatment and clinical factors, subjective concept of the illness and quality of life]. Fortschr Neurol Psychiatr 2002; 70: 410–417.

    Article  CAS  Google Scholar 

  5. Cutler DM, Everett W . Thinking outside the pillbox--medication adherence as a priority for health care reform. N Engl J Med 2010; 362: 1553–1555.

    Article  CAS  Google Scholar 

  6. Mena-Martin FJ, Martin-Escudero JC, Simal-Blanco F, Carretero-Ares JL, Arzua-Mouronte D, Herreros-Fernandez V . Health-related quality of life of subjects with known and unknown hypertension: results from the population-based Hortega study. J Hypertens 2003; 21: 1283–1289.

    Article  CAS  Google Scholar 

  7. Bardage C, Isacson D, Ring L, Bingefors K . A Swedish population-based study on the relationship between the SF-36 and health utilities to measure health in hypertension. Blood Press 2003; 12: 203–210.

    Article  Google Scholar 

  8. Alonso J, Ferrer M, Gandek B, Ware Jr JE, Aaronson NK, Mosconi P et al. Health-related quality of life associated with chronic conditions in eight countries: results from the International Quality of Life Assessment (IQOLA) Project. Qual Life Res 2004; 13: 283–298.

    Article  Google Scholar 

  9. Arslantas D, Ayranci U, Unsal A, Tozun M . Prevalence of hypertension among individuals aged 50 years and over and its impact on health related quality of life in a semi-rural area of western Turkey. Chin Med J (Engl) 2008; 121: 1524–1531.

    Article  Google Scholar 

  10. Wang R, Wu C, Zhao Y, Yan X, Ma X, Wu M et al. Health related quality of life measured by SF-36: a population-based study in Shanghai, China. BMC Public Health 2008; 8: 292.

    Article  Google Scholar 

  11. DeForge BR, Stewart DL, DeVoe-Weston M, Graham L, Charleston J . The relationship between health status and blood pressure in urban African Americans. J Natl Med Assoc 1998; 90: 658–664.

    CAS  PubMed  PubMed Central  Google Scholar 

  12. Thommasen HV, Zhang W . Impact of chronic disease on quality of life in the Bella Coola Valley. Rural Remote Health 2006; 6: 528.

    PubMed  Google Scholar 

  13. Trevisol DJ, Moreira LB, Kerkhoff A, Fuchs SC, Fuchs FD . Health-related quality of life and hypertension: a systematic review and meta-analysis of observational studies. J Hypertens 2011; 29: 179–188.

    Article  CAS  Google Scholar 

  14. Fuchs SC, Moreira LB, Camey SA, Moreira MB, Fuchs FD . [Clustering of risk factors for cardiovascular disease among women in Southern Brazil: a population-based study]. Cad Saude Publica 2008; 24: S285–S293.

    Article  Google Scholar 

  15. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003; 289: 2560–2572.

    Article  CAS  Google Scholar 

  16. Ware J, Kosinski M, Turner-Bowker DM, Gandek B . How to score version 2 of the SF-12 Health Survey (with a supplement documenting version 1). QualityMetric Incorporated: Boston, 2004.

    Google Scholar 

  17. Fayers P . Quality of life. Assessment, Analysis and Interpretation, 2nd edn. John Wiley & Sons: Chichester, England, 2000.

    Google Scholar 

  18. Ware JE, Snow K, Kosinski M, Gandek B . SF-36 Health Survey Manual and Interpretation Guide. New England Medical Center, The Health Institute, Boston, Massachussetts, 1993.

    Google Scholar 

  19. Campolina AG, Ciconelli RM . [SF-36 and the development of new assessment tools for quality of life]. Acta Reumatol Port 2008; 33: 127–133.

    PubMed  Google Scholar 

  20. Severo M, Santos AC, Lopes C, Barros H . [Reliability and validity in measuring physical and mental health construct of the Portuguese version of MOS SF-36]. Acta Med Port 2006; 19: 281–287.

    PubMed  Google Scholar 

  21. Gandek B, Ware JE, Aaronson NK, Apolone G, Bjorner JB, Brazier JE et al. Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol 1998; 51: 1171–1178.

    Article  CAS  Google Scholar 

  22. Fuchs FD, Moreira LB, Moraes RS, Bredemeier M, Cardozo SC . [Prevalence of systemic arterial hypertension and associated risk factors in the Porto Alegre metropolitan area. Populational-based study]. Arq Bras Cardiol 1994; 63: 473–479.

    CAS  PubMed  Google Scholar 

  23. Erickson SR, Williams BC, Gruppen LD . Perceived symptoms and health-related quality of life reported by uncomplicated hypertensive patients compared to normal controls. J Hum Hypertens 2001; 15: 539–548.

    Article  CAS  Google Scholar 

  24. de Gusmao JL, Mion Jr D, Pierin AM . Health-related quality of life and blood pressure control in hypertensive patients with and without complications. Clinics (Sao Paulo) 2009; 64: 619–628.

    Article  Google Scholar 

  25. Banegas JR, Lopez-Garcia E, Graciani A, Guallar-Castillon P, Gutierrez-Fisac JL, Alonso J et al. Relationship between obesity, hypertension and diabetes, and health-related quality of life among the elderly. Eur J Cardiovasc Prev Rehabil 2007; 14: 456–462.

    Article  Google Scholar 

  26. Cook EL, Harman JS . A comparison of health-related quality of life for individuals with mental health disorders and common chronic medical conditions. Public Health Rep 2008; 123: 45–51.

    Article  Google Scholar 

  27. Burstrom K, Johannesson M, Diderichsen F . Swedish population health-related quality of life results using the EQ-5D. Qual Life Res 2001; 10: 621–635.

    Article  CAS  Google Scholar 

  28. Anderson RT, Hogan P, Appel L, Rosen R, Shumaker SA . Baseline correlates with quality of life among men and women with medication-controlled hypertension. The trial of nonpharmacologic interventions in the elderly (TONE). J Am Geriatr Soc 1997; 45: 1080–1085.

    Article  CAS  Google Scholar 

  29. Gaynes BN, Burns BJ, Tweed DL, Erickson P . Depression and health-related quality of life. J Nerv Ment Dis 2002; 190: 799–806.

    Article  Google Scholar 

  30. Wells KB, Schoenbaum M, Unutzer J, Lagomasino IT, Rubenstein LV . Quality of care for primary care patients with depression in managed care. Arch Fam Med 1999; 8: 529–536.

    Article  CAS  Google Scholar 

  31. Wells KB, Sherbourne CD . Functioning and utility for current health of patients with depression or chronic medical conditions in managed, primary care practices. Arch Gen Psychiatry 1999; 56: 897–904.

    Article  CAS  Google Scholar 

  32. Li W, Liu L, Puente JG, Li Y, Jiang X, Jin S et al. Hypertension and health-related quality of life: an epidemiological study in patients attending hospital clinics in China. J Hypertens 2005; 23: 1667–1676.

    Article  CAS  Google Scholar 

  33. Neaton JD, Grimm Jr RH, Prineas RJ, Stamler J, Grandits GA, Elmer PJ et al. Treatment of Mild Hypertension Study. Final results. Treatment of Mild Hypertension Study Research Group. JAMA 1993; 270: 713–724.

    Article  CAS  Google Scholar 

  34. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. JAMA 1991; 265: 3255–3264.

    Article  Google Scholar 

  35. Goncalves CB, Moreira LB, Gus M, Fuchs FD . Adverse events of blood-pressure-lowering drugs: evidence of high incidence in a clinical setting. Eur J Clin Pharmacol 2007; 63: 973–978.

    Article  CAS  Google Scholar 

  36. Sparrenberger F, Fuchs SC, Moreira LB, Fuchs FD . Stressful life events and current psychological distress are associated with self-reported hypertension but not with true hypertension: results from a cross-sectional population-based study. BMC Public Health 2008; 8: 357.

    Article  Google Scholar 

  37. Banegas JR, Guallar-Castillon P, Rodriguez-Artalejo F, Graciani A, Lopez-Garcia E, Ruilope LM . Association between awareness, treatment, and control of hypertension, and quality of life among older adults in Spain. Am J Hypertens 2006; 19: 686–693.

    Article  Google Scholar 

  38. Gus M, Fuchs FD, Pimentel M, Rosa D, Melo AG, Moreira LB . Behavior of ambulatory blood pressure surrounding episodes of headache in mildly hypertensive patients. Arch Intern Med 2001; 161: 252–255.

    Article  CAS  Google Scholar 

  39. Wiehe M, Fuchs SC, Moreira LB, Moraes RS, Fuchs FD . Migraine is more frequent in individuals with optimal and normal blood pressure: a population-based study. J Hypertens 2002; 20: 1303–1306.

    Article  CAS  Google Scholar 

  40. Fuchs FD, Gus M, Moreira LB, Moreira WD, Goncalves SC, Nunes G . Headache is not more frequent among patients with moderate to severe hypertension. J Hum Hypertens 2003; 17: 787–790.

    Article  CAS  Google Scholar 

  41. Hagen K, Zwart JA, Holmen J, Svebak S, Bovim G, Stovner LJ . Does hypertension protect against chronic musculoskeletal complaints? The Nord-Trondelag Health Study. Arch Intern Med 2005; 165: 916–922.

    Article  Google Scholar 

  42. Badia X, Roca-Cusachs A, Dalfo A, Gascon G, Abellan J, Lahoz R et al. Validation of the short form of the Spanish Hypertension Quality of Life Questionnaire (MINICHAL). Clin Ther 2002; 24: 2137–2154.

    Article  Google Scholar 

  43. Cote I, Gregoire JP, Moisan J, Chabot I . Quality of life in hypertension: the SF-12 compared to the SF-36. Can J Clin Pharmacol 2004; 11: e232–e238.

    PubMed  Google Scholar 

  44. Lundberg L, Johannesson M, Isacson DG, Borgquist L . The relationship between health-state utilities and the SF-12 in a general population. Med Decis Making 1999; 19: 128–140.

    Article  CAS  Google Scholar 

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Acknowledgements

This study was supported by CNPQ, FAPERGS, HCPA (FIPE), UFRGS.

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Authors and Affiliations

  1. Postgraduate Studies Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

    D J Trevisol, L B Moreira, F D Fuchs & S C Fuchs

  2. Universidade do Sul de Santa Catarina, Tubarão, Brazil

    D J Trevisol

  3. Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil

    F D Fuchs

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  1. D J Trevisol
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Correspondence to F D Fuchs.

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Trevisol, D., Moreira, L., Fuchs, F. et al. Health-related quality of life is worse in individuals with hypertension under drug treatment: results of population-based study. J Hum Hypertens 26, 374–380 (2012). https://doi.org/10.1038/jhh.2011.48

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