Document Detail


Health-related quality of life and blood pressure control in hypertensive patients with and without complications.
MedLine Citation:
PMID:  19606236     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The goal of antihypertensive treatment is to reduce blood pressure without interfering in health-related quality of life (HRQL) OBJECTIVE: This study aimed to assess the influence of hypertension control upon HRQL in hypertensive patients with and without complications.
MATERIALS AND METHODS: Seventy-seven hypertensive outpatients (71% women, 58% white, 60% with elementary school level education, average age 54 +/- 8 years) were observed during a 12-month special care program (phase 1: clinical visits every two months, donation of all antihypertensive medications, meetings with a multidisciplinary team, and active telephone calls) and three years of standard care (phase 2: clinical visits every four months, medication provided by the drugstore of the hospital with a two-hour wait and a possible lack of medication, no meetings with a multidisciplinary team or active telephone calls). The patient HRQL was assessed using Bulpitt and Fletcher's Specific Questionnaire, as well as the SF-36 scores. Hypertensive patients were divided into "with complications" (n=37, diastolic blood pressure great than 110 mm Hg for patients with or without treatment, with clinically evident target-organ or other associated illness) and "without complications" (n=40). The variables studied were quality of life, blood pressure control, hypertension gravity, and demographic characteristics.
RESULTS: In hypertensive patients with and without complications, both the systolic and diastolic blood pressure were significantly higher (p<0.05) in phase 2 of observation (143+/-18/84+/-11 and 144+/-21/93+/-11 mm Hg for patients with and without complications, respectively) relative to phase 1 (128+/-17/75+/-13 and 128+/-15/83+/-11 mm Hg). The proportion of patients with controlled blood pressure (defined as a blood pressure less than 140/90 mm Hg) decreased from 70% to 49% in the "with complications" group and from 78% to 50% in the "without complications" group during phase 2 of observation. The patients with complications showed a decrease in bodily pain, vitality, and mental health component summary scores in both phases. In phase 2, the patients without complications had significantly better HRQL scores compared to complicated patients using both the Bulpitt and Fletcher's Questionnaire and the SF-36 assessment of physical capacity, bodily pain, and vitality domain summary scores. With regards to hypertension control, there was a significant decrease from phase 1 to phase 2 in the vitality component summary scores and an increase in the emotional aspect component summary scores assessed by the SF-36, whereas Bulpitt and Fletcher's Questionnaire showed no differences in these scores.
CONCLUSION: Special care programs with multidisciplinary activities, individualized and personalized assistance, easy access to pharmacological treatment, frequent meetings, and active telephone calls for hypertensive patients significantly increase blood pressure control but do not interfere with the HRQL.
Authors:
Josiane Lima de Gusmão; Decio Mion; Angela Maria Geraldo Pierin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinics (São Paulo, Brazil)     Volume:  64     ISSN:  1980-5322     ISO Abbreviation:  Clinics (Sao Paulo)     Publication Date:  2009  
Date Detail:
Created Date:  2009-07-16     Completed Date:  2010-08-02     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  101244734     Medline TA:  Clinics (Sao Paulo)     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  619-28     Citation Subset:  IM    
Affiliation:
Hypertension Unit, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo/SP, Brazil. josi@usp.br
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MeSH Terms
Descriptor/Qualifier:
Antihypertensive Agents / therapeutic use*
Blood Pressure / drug effects*
Brazil
Chi-Square Distribution
Female
Health Status*
Humans
Hypertension / complications,  drug therapy*,  physiopathology
Male
Middle Aged
Physical Fitness
Quality of Life*
Questionnaires* / standards
Statistics, Nonparametric
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antihypertensive Agents
Comments/Corrections

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