Abstract

This study aimed to determine the health-related quality of life (HRQoL) of people with self-reported diagnosed hypertension and its determinants in China. Data was obtained from the 5th National Health Services Survey. The HRQoL of the respondents who were 15 years or older was assessed with the EQ-5D-3L utility index and visual analogue scale (VAS), and compared between those with (n = 30,063) and without (n = 158,657) self-reported hypertension. Multivariate logistic regression, Tobit regression, and linear regression models were established to identify predictors of HRQoL. A difference of half standard deviation was deemed as minimal clinically important difference (MCID) for the utility index (0.03). The respondents with self-reported hypertension were more likely to report problems in the five dimensions (Adjusted Odds Ratio = 1.43–1.70) of the EQ-5D-3L, resulting in a significant lower utility index (β = −0.04) and VAS scores (β = −3.22) compared with those without self-reported hypertension, and the difference of the utility index exceeded MCID. In the respondents with self-reported hypertension, higher utility index and VAS scores were found in those who were female, younger, married, employed, smoking, drinking, exercising regularly, absent from comorbidity, resided in the eastern developed region, had normal body mass index, higher levels of education, and income. Hypertension management programs were associated with higher utility index (β = 0.01) and VAS scores (β = 1.02). Overall, hypertension is associated with lower HRQoL. Higher socioeconomic status and participation in management programs for chronic conditions are independent predictors of higher HRQoL of hypertensive people. This study provides a national representative estimate on the HRQoL of hypertensive people in China, which can be used for calculating the burden of hypertension.

Highlights

  • Hypertension is the biggest single contributor to global burden of disease (GBD)

  • Pain/discomfort was the most frequently reported problem: 25.96% in hypertensive people compared with 10.08% in those without self-reported diagnosed hypertension (p < 0.001)

  • Problems in self-care were the least frequently reported: 8.01% in hypertensive people compared with 2.12% in those without self-reported diagnosed hypertension (p < 0.001) (Table 2)

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Summary

Introduction

Hypertension is the biggest single contributor to global burden of disease (GBD). Over the past few decades, the prevalence of hypertension increased substantially, resulting in significant loss of disability-adjusted life-years (DALYs) [1]. It was estimated that globally there were 1.13 billion adults with hypertension in 2015, compared with just 594 million in 1975 [2]. The prevalence of hypertension increased from 17.31% in 1990 to 20.53% in 2015, leading to an increase of annual deaths from 97.9. Res. Public Health 2019, 16, 1721; doi:10.3390/ijerph16101721 www.mdpi.com/journal/ijerph

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