Selke B, Marquis P, Lebrun T
CRESGE, Lille, France.
Drugs. 1998;56 Suppl 2:45-53. doi: 10.2165/00003495-199856002-00005.
This article reports on the economic, social and quality-of-life issues relating to hypertension. Although it does not claim to be a comprehensive review of the many studies available in this field, it does attempt to highlight the main areas of interest. From both a macro- and a micro-economic viewpoint, hypertension and its associated cardiovascular and renal diseases are characterized by high costs. Treatment costs can, for certain persons, represent a considerable obstacle and result in limited access to any form of care. Nevertheless, providing access to care does not necessarily ensure that an individual patient receives effective treatment. Socioeconomic factors can have varying degrees of influence on the success of any therapy, and can affect, for example, treatment compliance. An individual's awareness of his/her hypertension (the labelling effect) and the initiation of any form of long term treatment can have specific effects on quality of life; yet, in order to ensure adequate patient compliance, treatment should not impair quality of life. Evaluation of quality of life depends not only on the dimensions under investigation but also on the use of reliable, legitimate, sensitive and previously validated questionnaires. The use of such questionnaires has enabled the complex links between quality of life and blood pressure to be recognised. This in turn has led to an assessment of various drug treatments. Results would appear to indicate that hypertension and its treatment do indeed affect patients' quality of life, a factor that ultimately influences the approach to disease management and the choice of long term treatment.
本文报道了与高血压相关的经济、社会和生活质量问题。尽管它并非对该领域众多现有研究的全面综述，但确实试图突出主要的关注领域。从宏观和微观经济角度来看，高血压及其相关的心血管和肾脏疾病都具有高成本的特点。对于某些人来说，治疗费用可能是一个相当大的障碍，导致获得任何形式医疗服务的机会有限。然而，提供医疗服务并不一定能确保个体患者得到有效治疗。社会经济因素对任何治疗的成功可能有不同程度的影响，例如可能影响治疗依从性。个体对自身高血压的认知（标签效应）以及任何形式长期治疗的启动，都可能对生活质量产生特定影响；然而，为确保患者有足够的依从性，治疗不应损害生活质量。生活质量的评估不仅取决于所调查的维度，还取决于使用可靠、合理、敏感且先前已验证的问卷。此类问卷的使用使得人们认识到生活质量与血压之间的复杂联系。这进而促使对各种药物治疗进行评估。结果似乎表明，高血压及其治疗确实会影响患者的生活质量，而这一因素最终会影响疾病管理的方法和长期治疗的选择。
