Association Between Awareness, Treatment, and Control of Hypertension, and Quality of Life Among Older Adults in Spain

Abstract

This study examines the relationship between awareness, treatment and control of hypertension, and health-related quality of life (HRQL) among older adults in Spain. We conducted a cross-sectional study that included 3368 subjects representative of the Spanish population > or = 60 years of age. We assessed HRQL using the MOS 36-Item Short Form (SF-36) questionnaire, and blood pressure (BP) was measured under standardized conditions. Data were analyzed using linear regression, adjusted for HRQL predictors (age, educational level, tobacco use, alcohol consumption, body mass index, physical activity, number of chronic diseases, and social support). Neither hypertension nor antihypertensive drug treatment or control were associated with worse HRQL. These results were also observed for awareness of hypertension among men, but in women awareness of hypertension was associated with a statistically significant (P < .01) and clinically relevant reduction (a 4- to 7-point lower score) in all HRQL dimensions. This association remained in evidence on many SF-36 scales, even after additional adjustment for medical advice to lose weight, reduce salt intake, increase physical activity, and moderate alcohol consumption. After further adjustment for prescription of antihypertensive drugs, however, the association between hypertension awareness and HRQL lost statistical significance, declining by >30% on most SF-36 scales. Neither hypertension nor antihypertensive drug treatment or control appears to lower HRQL in the elderly Spanish population. Yet, among women, awareness of hypertension is associated with lower HRQL, irrespective of change of lifestyle recommended by the physician. The impact of hypertension labeling on HRQL might be attributable in part to prescription of antihypertensive drugs.