Abstract
BackgroundHypertension is a known risk factor for several chronic conditions including diabetes and cardiovascular diseases. However, little is known about its impact on Health-related quality of life (HRQoL) in the context of Bangladesh. This study aimed to evaluate the association of hypertension on HRQoL among Bangladeshi patients corresponding to the socio-demographic condition, comorbid conditions, treatment, and health outcomes.MethodsA hospital based cross-sectional study was conducted using a pre-tested structured questionnaire among patients with hypertension in 22 tertiary medical college hospitals in Bangladesh. The study recruited male and female hypertensive patients of age ≥18 years between July 2020 to February 2021 using consecutive sampling methods. Health related quality of life was measured using the widely-used index of EQ-5D that considers 243 different health-related attributes and uses a scale in which 0 indicates a health state equivalent to death and 1 indicates perfect health status. The five dimensions of the quality index included mobility, self-care, usual activities, pain or discomfort, and anxiety or depression. Ordered logit regression and linear regression models were used to estimate the predictors of comorbidity and HRQoL.ResultsOf the 1,912 hypertensive patients, 56.2% were female, 86.5% were married, 70.7% were either overweight or obese, 67.6% had a family history of hypertension, and 85.5% were on anti-hypertensive medication. Among the individuals with comorbidities, 47.6% had diabetes, 32.3% were obese, 16.2% had heart disease, 15% were visually impaired, and 13.8% were suffering from psychological diseases. HRQoL was found to be inversely proportional to the number of comorbidities. The most frequent comorbidities of diabetes and obesity showed the highest EQ- 5D mean utilities of 0.59 and 0.64, respectively.ConclusionsPrevalent comorbidities, diabetes and obesity were found to be the significant underlying causes of declining HRQoL. It is recommended that the comorbidities should be adequately addressed for better HRQoL. Special attention should be given to address mental health issues of patients with hypertension.
Highlights
Hypertension is a known risk factor for several chronic conditions including diabetes and cardiovascular diseases
With increasing life expectancy and a rise in the aging population, a large number of people are currently living with various chronic diseases worldwide which grossly impairs their Health Related Quality of Life (HRQoL) [1]
Maximum of the cases originated from low-and middle-income countries (LMICs) [3, 4]
Summary
Hypertension is a known risk factor for several chronic conditions including diabetes and cardiovascular diseases. Little is known about its impact on Health-related quality of life (HRQoL) in the context of Bangladesh. With increasing life expectancy and a rise in the aging population, a large number of people are currently living with various chronic diseases worldwide which grossly impairs their Health Related Quality of Life (HRQoL) [1]. Hypertension is a major risk factor for many cardiovascular, cerebrovascular, and renal diseases, which is emerging globally due to lifestyle changes and other factors [2]. In Bangladesh, hypertension is one of the ten leading reported causes of death. One out of five Bangladeshi adults have hypertension and approximately 4% of deaths in Bangladesh occur due to complications related to hypertensive disorders [5, 6]. According to a report of World Health Organization (WHO) published in 2018, the prevalence of hypertension in Bangladesh is 21% which is gradually becoming a medical and public health concern for Bangladesh [7]
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