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Volume 17, Issue 4, Pages e17-e26 (July 2010)
Abstract
Health-Related Quality of Life in Hypertension, Chronic Kidney Disease, and Coexistent Chronic Health Conditions
Ritu K. Soni, Anna C. Porter, James P. Lash, Mark L. UnruhCorresponding Author Informationemail address
With the increasing prevalence of hypertension, there has been a growing interest in understanding the health-related quality of life (HRQOL) of patients with hypertension. Although hypertension is often perceived as asymptomatic, it is associated with impaired HRQOL because of complications or comorbidities, awareness of the diagnosis, and adverse effects from antihypertensive medications. This article focuses on the literature published since 2000, on HRQOL in elderly hypertensive individuals as well as hypertensives with co-existent diseases, including chronic kidney disease, cardiovascular disease, and diabetes mellitus. Most of the studies found that hypertensive individuals with co-existent co-morbidities tend to have lower HRQOL than those with hypertension alone, and identified the number of co-morbid illnesses as an independent determinant of HRQOL. The most pronounced effect was noted in the physical function domains of HRQOL. Studies have also examined the effects on HRQOL of specific classes of antihypertensive drugs without specific demonstration of superiority of one drug class over another in terms of HRQOL measures. Although there is evidence in favor of angiotensin-converting enzyme–inhibition for improving renal and cardiovascular outcomes in hypertensive patients, its role in ameliorating HRQOL outcomes remains to be established.
Key Words: Hypertension, Quality of life, Chronic kidney disease, Aging, Cardiovascular diseases, Diabetes mellitus
Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA; Section of Nephrology, Department of Medicine, University of Illinois, Chicago, IL; and Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
Corresponding Author InformationAddress correspondence to: Mark Unruh, MD, MSc, Renal Electrolyte Division; University of Pittsburgh School of Medicine; 200 Lothrop Street, PUH-1111; Pittsburgh, PA 15213.
This work was supported by NIH DK66006 and DK77785 (Unruh). Dr. Unruh also receives grant support from the Paul Teschan Research Fund, Norman Coplon Research Award, and the Baxter Extramural Grant Program. Dr. Unruh serves on the Medical Advisory Board for Baxter Healthcare.
PII: S1548-5595(10)00067-4
doi:10.1053/j.ackd.2010.04.002
http://www.ackdjournal.org/article/S1548-5595%2810%2900067-4/abstract