Comparative assessment of determinants of health-related quality of life in hypertensive patients and normal population in south-west Nigeria

Aduragbenro D.A Adedapo,Onyinye O Akunne,Babatunde O Adedokun

doi:10.5414/cp202257

Abstract

Objective: Health-related quality of life (HRQOL) in hypertensive patients may be influenced by the presence and the knowledge of disease, beliefs associated with the disease, blood pressure (BP) control, and drug utilization. The impact of hypertension on HRQOL in hypertensive patients compared to the normal population has not been assessed in Nigeria, the most populous country in sub-Saharan Africa. This study compares HRQOL in hypertensive patients and the normal population; the effect of BP control and medication on HRQOL of hypertensive patients is also assessed. Materials and methods: A prospective cross-sectional study of 713 individuals, 606 were hypertensive patients attending the University College Hospital in Oyo State, Nigeria, while 107 were normal persons residing in Ibadan. Data on sociodemographic status, clinical variables, and drug utilization were collected. World health organization-quality of life short version (WHO-QOL-BREF) questionnaires were used to assess HRQOL of participants. Results: Hypertensive patients had poorer HRQOL compared with normal individuals in the physical health (p < 0.05), psychological (p < 0.01), and total quality of life domains. Blood pressure control had no effect on HRQOL in domain (p > 0.05). Drug use significantly worsened HRQOL of hypertensive patients in the psychological (p ˂ 0.01), social relationship (p < 0.01), and the total quality of life domains (p < 0.01). Multiple regression analysis showed that while income per month was positively predictive of physical, psychological, and total quality of life domains (r2 = 1.988, p=0.001; r2 = 3.710, p < 0.001; r2 = 2.748, p < 0.001), symptom count was negatively predictive of the same (r2 = –0.746, p = 0.005; r2 = 1.869, p < 0.001; and r2 = –1.094; p < 0.001), respectively. Reduced symptoms and higher income improved quality of life in hypertensive patients. Conclusion: The presence of hypertension and antihypertensive medication reduced HRQOL of hypertensive patients, although BP control surprisingly did not impact HRQOL. However, lower symptom count and higher income improved quality of life.

Highlights

Health-related quality of life (HRQOL) of individuals may be affected in most disease conditions, chronic, lifelong diseases such as hypertension
Health-related quality of life (HRQOL) in hypertensive patients may be influenced by the presence and the knowledge of disease, beliefs associated with the disease, blood pressure (BP) control, and drug utilization
The impact of hypertension on HRQOL in hypertensive patients compared to the normal population has not been assessed in Nigeria, the most populous country in sub-Saharan Africa

Summary

Introduction

Health-related quality of life (HRQOL) of individuals may be affected in most disease conditions, chronic, lifelong diseases such as hypertension. Hypertension, the most common noncommunicable disease affecting ~ a billion of the world’s population, is the most important risk factor in the development of cardiovascular and renal diseases [2], with many of the individuals being unaware of their status [3]. The goal of drug therapy should be to improve clinical outcomes of diseases and improve the quality of life of patients. Various instruments are available to assess HRQOL of individuals across cultures. HRQOL studies carried out in the hypertensive population suggest low quality of life when compared to normotensive individuals [6, 7, 8]. There are inconsistent reports of HRQOL among hypertensive patients with controlled blood pressure (BP) and those with uncontrolled BP; while some

Methods

Results

Conclusion