title: Longitudinal predictors of health-related quality of life in middle-aged and older adults with hypertension:  results of a population-based study.
abstract: OBJECTIVE
  The aim of the study was to assess the longitudinal association between cardiovascular risk factors including albuminuria and other variables (e.g. awareness of hypertension, number of types of antihypertensive drugs, comorbidity), and health-related quality of life (HRQOL) in a large cohort of patients with hypertension, over a follow-up period of 5 years.
  
  
  METHODS
  Nine thousand nine hundred and fifty-three participants of the ESTHER (Epidemiologische Studie zu Chancen der Verhütung, Früherkennung und optimierten Therapie chronischer Erkrankungen) study - a population-based cohort study of middle-aged and older adults aged 50-74 years at baseline - were recruited by general practitioners (GPs) in 2000-2002 and included in the follow-up (2005-2007). HRQOL at baseline and follow-up was measured using the Short-Form General Health Survey (SF-12). Mental component scores (MCS) and physical component scores (PCS) were calculated. Multiple linear regression models were used to determine longitudinal predictors of HRQOL at follow-up.
  
  
  RESULTS
  Four thousand, two hundred and three patients with hypertension (98.2%) responded to the SF-12 both at baseline and after 5 years and were therefore included in the study. Smoking status, BMI, diabetes, macroalbuminuria, comorbid diseases, history of depression, and lower HRQOL at baseline predicted lower PCS at the 5-year follow-up. Lower MCS after 5 years was predicted by smoking status, dyslipidaemia, a reported history of depression, and HRQOL at baseline. No significant association was detected between awareness of hypertension and any HRQOL component score after 5 years.
  
  
  CONCLUSIONS
  Macroalbuminuria and other variables related to increased cardiovascular risk have a negative impact on PCS. Suggestions of a link of treatment and awareness of hypertension with HRQOL from previous cross-sectional studies are not supported by our longitudinal findings.
authors.affiliation: Department of General Internal Medicine and Psychosomatics, Medical University Hospital Heidelberg, Heidelberg, Germany. imad.maatouk@med.uni-heidelberg.de
authors.forename: Imad
authors.initials: I
authors.lastname: Maatouk
authors.forename: Beate
authors.initials: B
authors.lastname: Wild
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Herzog
authors.forename: Daniela
authors.initials: D
authors.lastname: Wesche
authors.forename: Dieter
authors.initials: D
authors.lastname: Schellberg
authors.forename: Ben
authors.initials: B
authors.lastname: Schöttker
authors.forename: Heiko
authors.initials: H
authors.lastname: Müller
authors.forename: Dietrich
authors.initials: D
authors.lastname: Rothenbacher
authors.forename: Christa
authors.initials: C
authors.lastname: Stegmaier
authors.forename: Hermann
authors.initials: H
authors.lastname: Brenner
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011788:Quality of Life