JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
Department of Neurology, Jining No. 1 People's Hospital, Jining, Shandong, China.
Qual Life Res. 2021 Oct;30(10):2907-2917. doi: 10.1007/s11136-021-02853-x. Epub 2021 May 1.
To investigate the associations between cardiovascular health (CVH) metrics and health-related quality of life (HRQL) among patients with ischemic stroke in China, and further explore the role of physical and cognitive function in their associations.
This hospital-based study included 1714 patients with first-ever acute ischemic stroke (age ≥ 40 years; 36.7% women) who were admitted to two university hospitals in Shandong, China. We collected information on seven CVH metrics (smoking, body mass index, diet, physical activity, blood pressure, total cholesterol, and fasting blood glucose) through interviews, clinical examinations, and laboratory tests. EQ-5D-3L was used to assess HRQL. Cognitive and physical functioning was assessed by the Montreal Cognitive Assessment test and Barthel index, respectively. Data were analyzed using the general linear regression models.
The average score (SD) was 0.746 (0.23) for HRQL index and 72.7 (15.8) for self-rated health. Optimal levels of four individual CVH metric components (diet, physical activity, blood pressure, and blood glucose) and a higher composite CVH score were significantly associated with a greater HRQL index and better self-rated health (p < 0.05 for all). Physical dependence and cognitive impairment were associated with a lower HRQL index and poorer self-rated health status (p < 0.001). Furthermore, the relationships between CVH metrics and HRQL index varied by functional status, such that their associations were statistically significant only among people who had physical dependence or cognitive impairment.
Achieving a better cardiovascular health profile is associated with better quality of life among ischemic stroke survivors, primarily in those with physical or cognitive impairment.
探讨中国缺血性脑卒中患者心血管健康（CVH）指标与健康相关生活质量（HRQL）之间的关系，并进一步探讨身体和认知功能在其相关性中的作用。
本项基于医院的研究纳入了 1714 名首次急性缺血性脑卒中（年龄≥40 岁；女性占 36.7%）患者，他们均入住中国山东的两所大学医院。我们通过访谈、临床检查和实验室检测收集了 7 项 CVH 指标（吸烟、体重指数、饮食、身体活动、血压、总胆固醇和空腹血糖）的信息。使用 EQ-5D-3L 评估 HRQL。使用蒙特利尔认知评估测试和巴氏指数分别评估认知和身体功能。使用一般线性回归模型进行数据分析。
HRQL 指数的平均得分（SD）为 0.746（0.23），自我报告健康状况的平均得分（SD）为 72.7（15.8）。四项个体 CVH 指标成分（饮食、身体活动、血压和血糖）的最佳水平和更高的复合 CVH 评分与更高的 HRQL 指数和更好的自我报告健康状况显著相关（p 值均<0.05）。身体依赖和认知障碍与更低的 HRQL 指数和更差的自我报告健康状况相关（p 值均<0.001）。此外，CVH 指标与 HRQL 指数之间的关系因功能状态而异，只有在存在身体依赖或认知障碍的人群中，它们之间的关系才具有统计学意义。
在缺血性脑卒中幸存者中，实现更好的心血管健康状况与生活质量的提高相关，尤其是在存在身体或认知障碍的人群中。
