Relationship between symptoms and health-related quality of life in patients treated for hypertension.
OBJECTIVE
To determine the relationship between symptoms and health-related quality of life (HRQOL) in patients receiving drug therapy for hypertension.


METHODS
Cross-sectional survey.


METHODS
Outpatient general medicine and university-based hypertension clinics.


METHODS
All patients prescribed one or more antihypertensive drugs seen during a 6-month period in the clinics.


METHODS
Data were obtained from a mailed questionnaire and medical records.


RESULTS
Symptoms were measured by a symptom count and total symptom distress. Two scores derived from the Short Form-36 (SF-36)--the Physical Component Summary (PCS) and the Mental Component Summary (MCS)--were used to assess HRQOL. Responses were received from 125 of 220 patients (56.8%). Mean +/- SD values were 8.8 +/- 7.8 for symptom count, 31.6 +/- 46.2 for total symptom distress, 48.7 +/- 9.3 for PCS, and 51.6 +/- 10.1 for MCS. Higher symptom counts and symptom distress scores were strongly associated with lower HRQOL scores in multivariate models, with standardized coefficients from -0.62 to -0.41. These were greater in magnitude than any other predictor, including demographic information (age, sex, race, education level, income), disease variables (blood pressure, years of hypertension), and drug treatment (number of antihypertensive drugs and duration of regimen). Model-adjusted R2 values were 0.22-0.41.


CONCLUSIONS
Symptoms have a greater impact on HRQOL than patient characteristics, blood pressure, or drug-related factors. Among patients receiving drug therapy for hypertension, detailed review of symptoms may yield important information for assessing and improving HRQOL.
Erickson
Steven R
SR
Department of Clinical Sciences, College of Pharmacy, University of Michigan, Ann Arbor 48109-1065, USA. serick@umich.edu
Williams
Brent C
BC
Gruppen
Larry D
LD
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008824:Michigan; D008875:Middle Aged; D016017:Odds Ratio; D011788:Quality of Life; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D013997:Time Factors
D000959:Antihypertensive Agents