Health-related Quality Of Life In Hypertensive Patients Research Articles

Emotion regulation and the quality of life in patients with essential hypertension: a search for psychological targets

Background: Essential hypertension (HTN) is a chronic disease, which is associated with a reduction in the health related quality of life (HRQoL). Most studies have examined the relationship between HRQoL and medical or sociodemographic features, whereas the implementation of tasks related to increasing the HRQoL is not possible without taking psychological factors into account. Studies highlight the importance of emotion regulation in the course and treatment of HTN as well as in the development of psychological interventions for hypertensive patients. The purpose of the study is to investigate the relationship between cognitive emotion regulation strategies and the HRQoL in hypertensive patients. Material and methods: 30 patients with HTN (21 women and 9 men) aged 44–85 (M = 64.6, SD = 10.0) were recruited in Bydgoszcz (Poland). The patients filled out the Cognitive Emotion Regulation Questionnaire and the World Health Organization Quality of Life–BREF questionnaire. Results: All maladaptive cognitive coping strategies (e.g., catastrophizing, blaming others or rumination) were not related to HRQoL, whereas most adaptive cognitive coping strategies (positive reappraisal, refocus on planning or putting into perspective) were positively correlated with the HRQoL. In particular, positive reappraisal strategy has a highly significant role for the HRQoL in hypertensive patients. Conclusions: The role of adaptive cognitive coping strategies is significant in terms of implementing appropriate psychological support, including the improvement of the HRQoL for patients with HTN. Practical applications of the study are being discussed.

Evaluating the socio-demographic, economic and clinical (SDEC) factors on health related quality of life (HRQoL) of hypertensive patients using EQ-5D-5L scoring algorithm.

This study was conducted to determine the various socio-demographic, economic, and clinical variables (SDECVs) which influence the health-related quality of life (HRQoL) of hypertensive patients. Three hundred and fifty hypertensive patients participated in this study through a structured questionnaire and EQ 5D 5L. 211(60.28%) participants had stage 1, and 139 (39.7%) had stage 2 hypertension. No participants reported severe problems in any domain on EQ 5D 5L. Generalize Linear Model (GLM) was used to assess the association between HRQoL and SDECVs. The mean utility and VAS score was 0.64 (±0.15) and 63.17 (±11.01) respectively. The participants of the stage 1 hypertension group had a significantly better score on each domain of EQ 5D 5L as compared to stage 1 (0.027, 0.010, 0.00, 0.00, 0.048). No participant in either group reported extreme problems in any domain. Among socio-demographic factors, the males, non-smokers, income sharing, and healthy normal hypertensive patients had better HRQoL (0.009, 0.016, 0.019, and 0.003). A lower cost of treatment was also associated with better HRQoL (0.017). Among clinical variables, stage 1 hypertension had better HRQoL than stage 2(0.035). The number of prescribed antihypertensive drugs had no effect on the quality of life (0.253), however, the non-pharmacologic interventions such as reduction in salt and oil consumption (0.035), reduction in beverages consumption (0.0014) and increased water intake (0.010) had resulted in better QoL. The patients who reported dizziness had poor HRQoL while patients who had cardiac problems and diabetes reported a significantly lower EQ-VAS score. The effect of gender on the HRQoL of hypertensive patients who had comorbid conditions was significant in the case of renal, respiratory, visual problems, and dizziness where females had a lesser utility score than males. The study reports on significant determinants which should be taken into account in an attempt to improve the health-related quality of life of hypertensive patients.

Evaluating health related quality of life among hypertensive patients: An educational intervention study

The health care sector has shown increased interest in humanistic outcomes of therapy. Health related quality of life (HRQOL) evaluation among patients receiving treatment for chronic diseases is now widely applied. Hence, the effect of education on the HRQOL of hypertensive patients was evaluated in two tertiary health facilities; FMC, Yenagoa and NDUTH, Okolobiri in Bayelsa State, Nigeria. Trained Pharmacist interviewed willing hypertensive patients between 21-80 years of age at the cardiology clinics of the health facilities using the MINICHAL questionnaire which is specific for hypertension. A convenient sampling technique was adopted. Demographic characteristics were also obtained. The responses (425) were analyzed and observed. To evaluate the effect of drugs and educational intervention, an interactive health talks on hypertension was held at their cardiology clinic weekly for six weeks. Two months later the questionnaire was re-administered. The responses post intervention (297) was analyzed. The results were then compared. The MINICHAL rates HRQOL as best=0 to worst=51. HRQOL score of 12.96 to 8.00 in FMC Yenagoa and 8.70 to 8.55 in NDUTH Okolobiri, pre and post intervention respectively was observed. Though not significant (P=0.3998), the study revealed that educational intervention brought about a positive trend in demographic characteristics. Age, marriage and education were indicated as strong indicators of HRQOL. Educational intervention on hypertension improves patient’s HRQOL. Patients’ education and counseling should be a continuous tool in patient management.

Health Related Quality of Life (HRQoL) in Hypertensive Patients

Hypertension also called as increased blood pressure (BP) is a chronic disorder in which BP is persistently elevated in the main systemic arteries. The main risk factor for cardiovascular disorder is hypertension. It is common in almost all countries. It makes a silent and gradual progress. Quality of life is a wide term which mainly affects the physical health, psychological condition, level of independence, social relationships and personal beliefs of a person. The HRQoL in people with hypertension can be mostly affected by the disease condition itself or due to the adverse effects of the treatment. Determining the quality of life of patients with hypertension has become an important issue. The HRQoL of hypertensive patients can be improved if the treatment and lifestyle modifications are done correctly. Counseling the patients with hypertension regarding risk factors, lifestyle modifications and medication adherence can also improve the HRQoL. Several questionnaires are available for assessing the HRQoL of people with different disorders. This questionnaire or instrument can be categorized into two types: the questionnaires for a specific disease and the general questionnaire. The SF instrument was introduced in the United States of America by the RANDS Corporation’s Health Insurance researches. It has now been translated to more than 120 world languages. Short form instrument is divided into different types which includes SF-36, SF-12, SF-20 and many more. EuroQol created EQ5D as a standardized method for assessing health status to provide a clear, objective health measure for medical and economic evaluation. . The EQ5D instrument comprises of three versions: EQ-5D-5L, EQ-5D-3L and EQ-5D-Y. WHOQoL- BREF, is a generic questionnaire administered on its own which contain 26 items. The MINICHAL was developed or introduced in 2001 in Spain which contains 17 questions. The word MINICHAL was obtained from “Mini Cuestionario de Calidad de Vida en Hypertensión Arterial.

Health-related quality of life of hypertension in China: a systematic review and meta-analysis.

Many observational studies have shown a lower health-related quality of life (HRQOL) of hypertension patients. This study aimed to summarize the association between hypertension and HRQOL in the Chinese population. We systematically searched the observational studies in the following databases: Medline, PubMed, Embase, Science Citation Index, Chinese National Knowledge Infrastructure, VIP and WanFang Data from 1 January 1990 to 1 October 2017. A total of 33 studies were included in this systematic review. Twenty-one of them presented worse quality of life in hypertensive individuals. The meta-analysis showed lower scores in hypertensive individuals for the eight domains and physical components (-4.93; 95% confidence interval -8.40 to -1.47), and no statistical difference in mental components (-1.62; 95% confidence interval -4.26 to 1.02). Among Chinese patients, HRQOL of hypertensive patients is worse than that of normotensive individuals. These data suggest that maintenance of normotension offers benefits on patient-centered outcomes, in addition to other well established cardiovascular benefits.

The impact of drug related problems on health-related quality of life among hypertensive patients in Jordan.

Background:Hypertension is a major cause of cardiovascular diseases with a high prevalence in Jordan. No previous studies have been carried out to determine the effect of the presence of drug-related problems (DRPs) on the health-related quality of life (HRQOL) among hypertensive patients.Objectives:The purpose of this study was to identify the influence of different types of DRPs on the HRQOL of hypertensive patients.Methods:A total of 200 hypertensive patients were recruited in this cross-sectional correlation study that was conducted across the cardiac outpatient clinic at Jordan University Hospital. Ethical approval was obtained and patients were recruited using convenience sampling technique. During the study period, patients’ data was used to evaluate their quality of life using RAND-12 scale and to identify DRPs utilizing a systematic evidence based approach.Results:200 hypertensive patients (mean age 59.7 years (SD=10.2)) were recruited in this study. Patients showed a poor quality of life on both the physical and mental domains of the RAND-12 scale. The average number of DRPs was 5.1 (SD=2.3). Multiple linear regression analysis showed that among DRPs categories, non-adherence to medications, non-adherence to non-pharmacological therapies and inadequate knowledge about medications were among the main predictors of the poor physical domain of the RAND-12 (Beta= -0.149, -0.226 and -0.230 respectively, p-value < 0.05 for all). On the other hand, only non-adherence to medication and non-adherence to non-pharmacological therapies were significantly associated with poor mental domain of the RAND-12 (Beta= -0.208 and -0.191 respectively, p-value < 0.05 for both).Conclusion:Prevalence of DRPs among hypertensive patients is a concern that needs attention. These DRPs were associated with poor HRQOL on both the physical and mental domain of the RAND-12 scale. The pharmaceutical care service delivered by pharmacists is needed to identify, prevent and resolve DRPs, which may improve patients HRQOL.

The effect of health literacy and self-management efficacy on the health-related quality of life of hypertensive patients in a western rural area of China: a cross-sectional study

BackgroundHypertension is a common and frequently occurring chronic disease of the cardiovascular system. Besides the pathological factors, the occurrence and exacerbation of hypertension are also associated with many factors of lifestyle and behaviors. Thus hypertensive patients’ Health-related quality of life (HRQL) is not only influenced by the disease itself but also by many subjective factors such as health literacy and self-management efficacy, especially in the deeper part of southwestern China and thus is less developed compared to the other places. The purpose of this study was to examine the association between the HRQL of hypertensive patients and health literacy and self-management efficacy as well as how they affect the HRQL, so as to provide a theoretical reference for improving the HRQL of patients with hypertension in less developed areas.MethodsThis was a cross-sectional study of baseline data from a clustered randomized controlled trial. The study design had passed a cross-national peer review and accepted grants by the China Medical Board. It was also registered in the Chinese Clinical Trial Registry (ChiCTR-OOR-14005563).A standardized questionnaire adapted from a previous validated WHO questionnaire was used for the survey which included detailed questions about patient’s socio-demographic characteristics and self-reported information.Patients’ HRQL was measured by the Mandarin version of the 36-item Short Form. We used the validated Mandarin version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale to assess patients’ self-management efficacy. The validated three-item Brief Health Literacy Screening (BHLS) was used to measure the patients’ health literacy.A structural equation model was constructed, and p ≤ 0.05 was taken as significant.ResultsDemographic characteristics, health literacy and self-management efficacy have all significant effects on HRQL. Age, education level, self-management efficacy and health literacy were significantly related to the HRQL. The constructed model had a good fit for the data according to the model fit indices. Based on the model, health literacy (r = 0.604, p = 0.029) and Self-management efficacy (r = 0.714, p = 0.018) have a significant impact on HRQL. Demographic characteristics were inversely related to HRQL (r = −0.419, p = 0.007), but have a significant impact on health literacy (r = 0.675, p = 0.029) and self-management efficacy (r = 0.379, p = 0.029). At the same time, self-management efficacy was positively correlated to health literacy (r = 0.413, p < 0.01).ConclusionsAge, education level, self-management efficacy and health literacy were all related to the HRQL of patient with hypertension, which means that patients who are more elderly and have lower education level, low self-management efficacy and poor health literacy get worse HRQL. This may imply the necessary to introduce routine assessment of health literacy and self-management efficacy into assessment procedures for hypertensive patients’ health management. Such assessment can help professionals to identify the population at greatest risk for poor health outcomes and low well-being in the future. In clinical practice, effective interventions such as direct guidance and education to raise the self-management efficacy and enhance health literacy might improve the HRQL of patients with hypertension.Trial registrationRetrospectively registered Chinese Clinical Trial Registry (ChiCTR-OOR-14005563).Name of registry: Effects of the integrated delivery system and payment system of community-based intervention on rural patients of chronic diseases in Qianjiang District, ChinaDate of registration: Retrospectively registered 23 November 2014.Date of enrolment of the first participant to the trial: 5 July 2012

Efficacy of Chinese herbal medicine on health-related quality of life (SF-36) in hypertensive patients: A systematic review and meta-analysis of randomized controlled trials

This study aims to evaluate published randomized controlled trials (RCTs) of Chinese Herbal Medicine (CHM) improving health-related quality of life (HRQL) in hypertensive patients that employ the Short-Form 36-Item Health questionnaire (SF-36) as an outcome measure. Five electronic databases were searched up to October 2013 to identify RCTs of CHM for hypertension. The primary outcome was SF-36. Trial selection, data extraction, methodological quality assessment, and data analyses were conducted according to the Cochrane handbook. Eleven RCTs with total of 1043 participants were identified. The majority of the included trials were assessed to be of poor methodological quality and high clinical heterogeneity. Meta-analysis shows a significant improvement both in physical component summary (PCS) measure and mental component summary (MCS) measure of SF-36, with physical functioning (WMD=8.54[5.34, 11.74], p<0.001), role physical (WMD=13.32[7.03, 19.61], p<0.001), bodily pain (WMD=10.53[6.46, 14.60], p<0.001), general health (WMD=-5.56[2.09, 9.02], p<0.001), vitality (WMD=6.84[4.33, 9.53], p<0.001), social functioning (WMD=7.50[2.63, 12.36], p<0.001), role emotional (WMD=12.06[4.45, 19.68], p<0.001) and mental health (WMD=-5.68[2.90, 8.47], p<0.001). CHM can also decrease systolic blood pressure (WMD=-4.45 [-6.71, -2.19], p<0.001) and relieve symptoms related to hypertension. CHM appears to have beneficial effects on improvement of HRQL in hypertensive patients. However, the findings should be interpreted with caution due to the poor methodological quality and high clinical heterogeneity of the included trials. Further clinical trials should be carried out to provide more reliable evidence.

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

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.

Health-related quality of life and awareness of hypertension

It has been shown that individuals with hypertension have poorer health-related quality of life (HRQoL) than normotensive individuals. However, little is known about the impact of high blood pressure and the awareness to have hypertension on HRQoL. In this cross-sectional population-based study, we evaluated 901 cardiovascular risk patients aged 45 to 70 years without serious comorbidities. Hypertension was detected in 497 (55%) of the patients, in whom 137 (28%) had previously undiagnosed hypertension confirmed with home blood pressure measurement. Before the diagnosis of hypertension was made, the patients filled Short-Form Health Survey (SF-36) to assess their HRQoL. Glucose homeostasis was assessed with 2 h oral glucose tolerance test. Patients who were aware of their hypertension had lower scores in physical functioning and general health than patients without hypertension and patients who were unaware of hypertension. There were no differences for mental components of SF-36 between these study groups. The prevalence of obesity and newly diagnosed type 2 diabetes was higher in patients with known hypertension than among other study groups. Impaired HRQoL in hypertensive patients might be secondary to the awareness of hypertension, adverse drug effects, newly diagnosed type 2 diabetes or obesity, not high blood pressure per se.

Health-related quality of life in patients treated for hypertension: A review of the literature from 1990 to 2000

Background: The goals of antihypertensive therapy are to achieve and maintain blood pressure control by the least intrusive means possible to prevent future cardiovascular and renal events. To achieve these goals, pharmacologic agents must be chosen so as to minimize drug-related adverse events, increase patient adherence to treatment regimens, and minimize the negative impact on health-related quality of life (HRQL). Although the effects of antihypertensive therapy on HRQL have been extensively investigated, there is little synthesis of the research findings. Objective: This review was undertaken to provide a synthesis of the available data on the impact of antihypertensive therapy on HRQL and to provide recommendations for future research. Methods: A MEDLINE literature search was conducted to identify English-language articles published from 1990 to 2000 that included random assignment to antihypertensive treatment and HRQL as an outcome. In addition, reference lists of published reviews and other trials were reviewed to identify other studies of HRQL and antihypertensive therapy. Results: A total of 48 articles were included in the review. Results among studies were frequently inconsistent, which is likely due to the wide variety of dimensions studied and instruments used as well as a number of methodological weaknesses, including small sample sizes, short-term assessments, and failure to account for missing data. Conclusion: A standardized approach to the assessment of HRQL in hypertensive patients is needed so that research in this area can be of value to clinical practice and to hypertensive patients and their families.