Klocek Marek, Kawecka-Jaszcz Kalina
I Klinika Kardiologii, Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie, 31-501 Kraków, ul. Kopernika 17.
Przegl Lek. 2003;60(2):101-6.
The aim of the study was to evaluate the effect of clinical factors on variation in the health-related quality of life (HRQoL) of patients with arterial essential hypertension. An open questionnaire study was performed among 1539 subjects (775 men and 764 women) aged from 18 to 88 years (mean age 51.7 +/- 14.6 years) with arterial hypertension diagnosed at least 3 months earlier. The patients had been treated (86.2%) or started treatment (17.4%) in municipal outpatient units and in the Antihypertensive Outpatient Center of the I Cardiac Department. The following data were analyzed: systolic and diastolic blood pressure, heart rate, body mass, target organ complications and number of hypotensive drugs. All patients completed a standardized Psychological General Well-Being questionnaire (PGWB) to evaluate the general quality of life and its six dimensions: anxiety, depressive mood, well-being, self-control, general health and vitality. Irrespective of the patients' gender the general quality of life was poorer in those patients in whom systolic blood pressure exceeded 140 mmHg. The highest general quality of life was observed in patients with diastolic blood pressure between 74 and 90 mmHg. In patients with BMI > 30 kg/m2 the HRQoL was significantly lower. In obese patients as compared with normal and overweight patients the following scales of the PGWB were significantly lower: general health and vitality, whereas the score of depressive mood was higher (p < 0.05). Furthermore obese patients had significantly higher SBP and DBP than slim subjects. Both in men and women with arterial hypertension there was a negative relationship between the quality of life and the presence of target organ complications and the number of drugs used. Among the patients treated with 4 and more hypotensive drugs the proportion of subjects with controlled blood pressure was lower as compared with those receiving 1, 2 or 3 drugs. Multiple regression analysis showed that the clinical factors independently affecting the general quality of life in patients with arterial hypertension were systolic and diastolic blood pressure, obesity, target organ complications and the number of hypotensive drugs used. These factors accounted for 37.1% of variance in the general quality of life.
本研究旨在评估临床因素对原发性高血压患者健康相关生活质量（HRQoL）变化的影响。对1539名年龄在18至88岁（平均年龄51.7 +/- 14.6岁）的受试者（775名男性和764名女性）进行了一项开放式问卷调查研究，这些受试者至少在3个月前被诊断为动脉高血压。患者在市政门诊单位和第一心脏科的抗高血压门诊中心接受过治疗（86.2%）或开始接受治疗（17.4%）。分析了以下数据：收缩压和舒张压、心率、体重、靶器官并发症以及降压药数量。所有患者均完成了一份标准化的心理总体幸福感问卷（PGWB），以评估总体生活质量及其六个维度：焦虑、抑郁情绪、幸福感、自我控制、总体健康和活力。无论患者性别如何，收缩压超过140 mmHg的患者总体生活质量较差。舒张压在74至90 mmHg之间的患者总体生活质量最高。体重指数（BMI）> 30 kg/m2的患者健康相关生活质量显著较低。与正常体重和超重患者相比，肥胖患者的PGWB以下量表得分显著较低：总体健康和活力，而抑郁情绪得分较高（p < 0.05）。此外，肥胖患者的收缩压和舒张压显著高于体型苗条的受试者。在患有动脉高血压的男性和女性中，生活质量与靶器官并发症的存在以及所用药物数量之间均呈负相关。在接受4种及以上降压药治疗的患者中，血压得到控制的受试者比例低于接受1、2或3种药物治疗的患者。多元回归分析表明，独立影响动脉高血压患者总体生活质量的临床因素是收缩压和舒张压、肥胖、靶器官并发症以及所用降压药的数量。这些因素占总体生活质量方差的37.1%。
