Health-related quality of life and hypertension: a systematic review and meta-analysis of observational studies

• Published in: Journal of hypertension Vol. 29; no. 2; pp. 179 - 188
• Main Authors: Trevisol, Daisson J, Moreira, Leila B, Kerkhoff, Alessandra, Fuchs, Sandra C, Fuchs, Flávio D
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-02-2011; Lippincott Williams & Wilkins
• Subjects: Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Data Interpretation, Statistical; Female; Health Surveys - statistics & numerical data; Humans; Hypertension - physiopathology; Hypertension - psychology; Male; Medical sciences; Quality of Life - psychology; Hypertension; meta-analysis; Cardiovascular disease; systematic review; Quality of life
• ISSN: 0263-6352; 1473-5598
• DOI: 10.1097/HJH.0b013e328340d76f

OBJECTIVEMost, but not all cross-sectional surveys have identified lower quality of life among patients with hypertension. We summarized the estimates for this association in a systematic review and in a meta-analysis of cross-sectional studies.
METHODSStudies that used the Short-Form Health Survey (SF) to compare the quality of life of normotensive and hypertensive individuals were searched in Embase, MEDLINE/PubMed, LILACS, Ovid, ScienceDirect, SciELO and Cochrane databases using ‘hypertension’ and ‘quality of life’ medical subject heading (MeSH) terms and the words ‘health survey, SF-12, SF-36 and their spelling variations (SF12, SF 12, SF36 and SF 36)’. Data extraction was conducted by two researchers. Data were analyzed with MIX 1.7 using random effects model. Results of the meta-analysis were expressed as differences of mean scores between hypertensive and normotensive individuals.
RESULTSMost of the 20 studies selected for the systematic review identified lower quality of life in patients with hypertension, but they were very heterogeneous in regard to selection criteria and comparison groups, limiting their external validity. The meta-analysis identified lower scores in hypertensive patients for physical [−2.43; 95% confidence interval (CI) −4.77 to −0.08] and mental (−1.68; 95% CI −2.14 to −1.23) components. Quality of life was lower in the eight domains of the SF-36physical and functional functioning, role physical and emotional, bodily pain, general health, vitality and mental health.
CONCLUSIONQuality of life of individuals with hypertension is slightly worse than that of normotensive individuals. The influence of high blood pressure and of the awareness to have hypertension requires further investigation.