[Quality of life in patients with essential arterial hypertension. Part II: The effect of clinical factors].

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.