Anderson R T, Hogan P, Appel L, Rosen R, Shumaker S A
Dept of Public Health Sciences, Bowman Gray School of Medicine, Winston-Salem, NC 27157, USA.
J Am Geriatr Soc. 1997 Sep;45(9):1080-5. doi: 10.1111/j.1532-5415.1997.tb05970.x.
To examine Quality of Life (QOL) and its correlates among older adults with medication-controlled hypertension.
Baseline data from the TONE clinical trial.
Demographic variables (age, race, income), hypertension treatment (medication class, years treated), health status (obesity, physical symptoms), and QOL status (MOS-Short-Form 36, Jenkins Sleep Disturbance, and CES-D Depression).
A total of 975 men and women, aged 60 to 81 years and free of major diseases and disability, with a screening blood pressure (BP) of < or = 145/85 mm Hg, treated medically for hypertension with antihypertensive medication.
On average, TONE participants reported a QOL level on the SF-36 that was similar to or better than that reported by older adults in the general population. However, there was a strikingly high prevalence of physical complaints or symptoms: 90.3% of men and 93.3% of women experienced one or more physical symptoms or complaints, and nearly 50% reported that such symptoms had disrupted their daily functioning. Among variables-considered, only the physical symptoms index score, number of severe symptoms, and obesity status were correlated consistently with QOL among TONE men and women. Lower QOL scores were associated with higher symptom scores and with obesity. Neither medication class nor age were appreciably associated with QOL status.
Physical symptoms, rather than medication class and age, were the strongest correlates of QOL in TONE. This underscores the importance of identifying the etiology of symptoms as a means to improve the QOL of order hypertensive persons rather than substituting medication. The association of poorer physical well-being with obesity suggests that weight reduction to manage BP may also improve QOL for some individuals.
研究药物控制的老年高血压患者的生活质量（QOL）及其相关因素。
来自TONE临床试验的基线数据。
人口统计学变量（年龄、种族、收入）、高血压治疗情况（药物类别、治疗年限）、健康状况（肥胖、身体症状）以及生活质量状况（医学结局研究简表36项健康调查、詹金斯睡眠障碍量表和流调中心抑郁量表）。
共有975名年龄在60至81岁之间、无重大疾病和残疾、筛查血压（BP）≤145/85 mmHg且正在接受抗高血压药物治疗的高血压患者。
总体而言，TONE研究参与者在SF-36量表上报告的生活质量水平与普通人群中的老年人相似或更好。然而，身体不适或症状的患病率极高：90.3%的男性和93.3%的女性经历过一种或多种身体症状或不适，近50%的人报告这些症状干扰了他们的日常功能。在所有考虑的变量中，只有身体症状指数得分、严重症状数量和肥胖状况与TONE研究中的男性和女性的生活质量始终相关。较低的生活质量得分与较高的症状得分和肥胖有关。药物类别和年龄与生活质量状况均无明显关联。
在TONE研究中，身体症状而非药物类别和年龄是生活质量的最强相关因素。这凸显了识别症状病因作为改善老年高血压患者生活质量手段的重要性，而不是更换药物。身体状况较差与肥胖之间的关联表明，通过减轻体重来控制血压可能也会改善一些人的生活质量。
