The impact of therapy on the quality of life in asymptomatic patients with freshly detected hypertension

Satish Chandra Mishra, Vishal Singh, Sudeep Prakash, Pushkar Pandey


Background: Hypertension is an commonly encountered disease which adversely affect  all aspects of quality of life (QoL). The existing studies are confounded by the presence of multiple comorbidities and inclusion of elderly, which by themselves impairs the QoL. There is thus a need to study the impact of hypertension on QoL, in isolation.

Method: This is a single center, prospective, intention to treat, observation study. The aim of the study is to evaluate the change in the QoL over six months, in newly diagnosed asymptomatic patients of hypertension. The tools used to assess the QoL included World Health Organisation’s Quality of Life Questionnaire (WHOQOL- BREF) and Short Form-36 (SF-36).

Result: A total of 232 patients (172 males and 60 females) were enrolled in the study. The mean age was 44.66 years. A total of 102 patients (43.97%) had stage-1 and 130 patients (56.03%) had stage-2 hypertension. The female gender is associated with a higher likelihood of presentation with stage-2 hypertension. The male cohort had a better baseline QoL. The desired blood pressures was achieved in 40.52%. With therapy, the QoL improved significantly; sub-hoc analysis showed, the improvement was higher in males and those with stage-1 hypertension. There is an inverse relationship between the QoL and requirement for higher number of antihypertensive mediations.

Conclusions: In patients with asymptomatic primary hypertension, treatment improves all aspects of QoL. The factors adversely affecting the QoL include female gender, higher stage of hypertension, poor blood pressure control and requirement of higher numbers of antihypertensive medicine.


Hypertension, Quality of Life, Short Form 36, World Health Organisation’s Quality of Life Questionnaire

Full Text:



Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report. JAMA. 2003;289(19):2560-72.

Reddy KS, Shah B, Varghese C, Ramadoss A. Responding to the threat of chronic diseases in India. Lancet. 2005;366(9498):1744-9.

Gupta R. Trends in hypertension epidemiology in India. J Human Hypertension. 2004 Feb;18(2):73-8.

WHOQOL Group. Development of the WHOQOL: Rationale and current status. Int J Mental Health.1994;23(3):24-56.

Jenkinson C, Wright L, Coulter A. Criterion validity and reliability of the SF-36 in a population sample. Qual Life Res. 1994;3(1):7-12.

Youssef RM, Moubarak II, Kamel MI. Factors affecting quality of life of hypertensive patients. Eastern Mediterranean health J. 2005;11(1-2):109-18.

Poljičanin T, Ajduković D, Šekerija M, Pibernik-Okanović M, Metelko Ž, Mavrinac GV. Diabetes mellitus and hypertension have comparable adverse effects on health-related quality of life. BMC Public Health. 2010;10(1):12.

Stewart AL, Greenfield S, Hays RD, Wells K, Rogers WH, Berry SD, et al. Functional status and well-being of patients with chronic conditions: results from the Medical Outcomes Study. JAMA. 1989;262(7):907-13.

Aydemir O, Ozdemir C, Koroglu E. The impact of co-morbid conditions on the SF-36: a primary-care-based study among hypertensives. Arch Med Res. 2005;36(2):136-41.

Croog SH, Levine S, Testa MA, Brown B, Bulpitt CJ, Jenkins CD, et al. The effects of antihypertensive therapy on the quality of life. New England J Med. 1986;314(26):1657-64.

Wiklund I, Halling K, Ryden-Bergsten T, Fletcher A. Does lowering the blood pressure improve the mood? Quality-of-life results from the Hypertension Optimal (HOT) Study. Blood Press. 1997;6(6):357-64.

Fletcher AE, Bulpitt CJ, Chase DM, et al .Quality of life with three antihypertensive treatments. Cilazapril, atenolol, nifedipine. Hypertension. 1992;19(6):499-507.

Marcia A, Testa MA, Anderson RB. Nackley JF, Hollenberg NK. Quality of Life and Antihypertensive Therapy in Men -- A Comparison of Captopril with Enalapril. NEJM. 1993;328(13):907-13.

Roca-Cusachs A, Dalfo A, Badia X, Aristegui I, Roset M. Relation between clinical and therapeutic variables and quality of life in hypertension. J Hypertens. 2001;19(10):1913-9.

Li W, Liu L, Puente JG, Li Y, Jiang X, Jin S, et al. Hypertension and health-related quality of life: an epidemiological study in patients attending hospital clinics in China. J Hypertension. 2005;23(9):1667-76.

Staessen JA, Fagard R, Thijs L, Celis H, Arabidze GG, Birkenhäger WH, et al. Randomised double-blind comparison of placebo and active treatment or older patients with isolated systolic hypertension. Lancet. 1997;350(9080):757-64.

Roca-Cusachs A, Dalfó A, Badia X, Arístegui I, Roset M. Relation between clinical and therapeutic variables and quality of life in hypertension. J Hypertension. 2001;19(10):1913-9.

Materson BJ, Reda DJ, Cushman WC, Massie BM, Freis ED, Kochar MS, et al. Single-Drug Therapy for Hypertension in Men-A Comparison of Six Antihypertensive Agents with Placebo. New England J Med. 1993;328(13):914-21.