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Lee CJ, Park WJ, Suh JW, Choi EK, Jeon DW, Lim SW, Kim DH, Cha KS, Lee BR, Kim NH, Kang TS, Ha JW. Relationship between health-related quality of life and blood pressure control in patients with uncontrolled hypertension. J Clin Hypertens (Greenwich) 2020; 22:1415-1424. [PMID: 32652901 DOI: 10.1111/jch.13941] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/30/2020] [Accepted: 05/17/2020] [Indexed: 11/27/2022]
Abstract
We sought to investigate the psychosocial characteristics of patients with uncontrolled hypertension and examine factors that influence blood pressure (BP) control. A total of 1011 patients with uncontrolled hypertension were enrolled in 13 tertiary hospitals. Uncontrolled hypertension was defined as systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg despite on antihypertensive therapy. Socio-demographics, anthropometrics, behavioral risk factors, medication pattern, adherence, and measures of health-related quality of life (HRQoL; EuroQol 5D visual analog scale [EQ-5D VAS]) were assessed at baseline and during follow-up visits (3 and 6 months). Patients were divided into 2 groups based on BP control status at 6 months (controlled group [n = 532] vs uncontrolled group [n = 367]). There were no differences in clinical characteristics except the proportion of smokers and baseline BP between patients with controlled BP and uncontrolled BP. At 6 months, the adherence of antihypertensive medication did not differ between the groups but the proportion of combination therapy with ≥3 antihypertensives was significantly higher in patients with uncontrolled BP. EQ-5D VAS at follow-up was significantly lower in patients with uncontrolled BP despite similar baseline values. Multivariate logistic regression analysis revealed that EQ-5D VAS at follow-up significantly correlated with BP control. Patients with worse HRQoL had higher Charlson Comorbidity Index and higher proportion of taking ≥3 antihypertensives, but medication adherence was similar to those with better HRQoL. These findings suggest that along with pharmacologic intervention of hypertension, management of comorbid conditions or psychological support might be helpful for optimizing BP control in patients with uncontrolled hypertension.
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Affiliation(s)
- Chan Joo Lee
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Woo Jung Park
- Division of Cardiology, Department of Internal Medicine, Hallym University Pyeongchon Sacred Heart Hospital, Anyang, Republic of Korea
| | - Jung-Won Suh
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Eue-Keun Choi
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dong Woon Jeon
- Department of Cardiology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Sang-Wook Lim
- Division of Cardiology, Department of Internal Medicine, CHA Bundang Medical Center, Seongnam, Republic of Korea
| | - Dae-Hyeok Kim
- Department of Cardiology, Inha University College of Medicine, Incheon, Republic of Korea
| | - Kwang Soo Cha
- Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Bong-Ryeol Lee
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - Nam-Ho Kim
- Division of Cardiology, Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Republic of Korea
| | - Tae-Soo Kang
- Division of Cardiology, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Jong-Won Ha
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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The relationships between timing of first childbirth, parity, and health-related quality of life. Qual Life Res 2017; 27:937-943. [PMID: 29280040 DOI: 10.1007/s11136-017-1770-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2017] [Indexed: 12/13/2022]
Abstract
PURPOSE A few studies have investigated the relationship between age at first childbirth and health-related quality of life (HRQoL). This study examined the relationship between age at first childbirth and HRQoL and whether parity mediates this timing of the first childbirth-HRQoL relationship in women aged 50 years or above. METHODS The study population included 5146 parous women ≥ 50 years in the cross-sectional survey, the Korea National Health and Nutrition Examination Survey 2010-2012. HRQoL was evaluated by the EuroQol five-dimensional descriptive system. Participants were grouped according to quartiles of age at first childbirth (ranges: 13-21, 22-23, 24-25, and 26-44 years). This study used linear regression analysis to examine the relationship between age at first childbirth and HRQoL and on each dimension. Mediation analysis was used to examine the contribution of age at first childbirth to HRQoL and to each dimension. RESULTS This study found the increasing pattern of HRQoL across quartiles of age at first childbirth (P for trend = 0.030). Odds of problems in self-care and anxiety/depression dimensions significantly increased across the quartiles. Women with later age at first childbirth tended to have better HRQoL (B = 0.352, P = 0.003); parity significantly contributed to this relationship. Decreasing parity accounted for 33.5% of the relationship between late first childbirth and increased HRQoL. Early age at first childbirth significantly increased odds of the mobility problem through increasing parity. CONCLUSIONS Women of an early age at first childbirth tended to have lower HRQoL through giving more deliveries. Our findings suggest that more attention needs to be given to women with early pregnancy and more delivery to prevent impaired HRQoL.
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Bonaccio M, Di Castelnuovo A, Costanzo S, Persichillo M, De Curtis A, Cerletti C, Donati MB, de Gaetano G, Iacoviello L. Health-related quality of life and risk of composite coronary heart disease and cerebrovascular events in the Moli-sani study cohort. Eur J Prev Cardiol 2017; 25:287-297. [PMID: 29243510 DOI: 10.1177/2047487317748452] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background To assess the association between health-related quality of life (HRQL) and a composite outcome including incident coronary heart disease (CHD) and cerebrovascular events in a large general population-based cohort. Design Prospective analysis on 17,102 men and women (mean age 53 ± 11) free from cardiovascular disease at time of enrolment in the Moli-sani cohort (2005-2010). Methods HRQL was assessed by the 36-Item Short Form Health Survey. Hazard ratios with 95% confidence intervals (95% CIs) were calculated using multivariable Cox-proportional hazard models. Results At the end of follow-up (median 4.2 years), 237 new events occurred (coronary heart disease n = 197, cerebrovascular disease n = 42). In a multivariable model adjusted for socioeconomic factors, chronic disease and health-related behaviours, both mental and physical HRQL were inversely associated with the risk of the composite outcome (hazard ratio = 0.57; 0.39-0.84 and hazard ratio = 0.62; 0.40-0.94, respectively; highest vs. lowest quartile). Further adjustment for C-reactive protein marginally modified the association with physical HRQL (hazard ratio = 0.67; 0.43-1.02). Similar findings were obtained when only CHD events were analysed (hazard ratio = 0.63; 0.41-0.96 for highest versus lowest mental HRQL) although results with physical HRQL were no longer significant (hazard ratio = 0.65; 0.40-1.04 for highest versus lowest quartile). Associations with incident cerebrovascular disease showed a trend toward protection (hazard ratio = 0.50; 0.22-1.17 and hazard ratio = 0.51; 0.22-1.23 for highest versus lowest tertile of mental and physical HRQL, respectively). Conclusions HRQL is an independent predictor of composite CHD/cerebrovascular outcomes in an adult population. The magnitude of the association was not affected either by socioeconomic factors, health conditions or health-related behaviours. Improvement of quality of life may be a major factor in targeting appropriate prevention strategies for cardiovascular health.
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Affiliation(s)
- Marialaura Bonaccio
- 1 Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
| | - Augusto Di Castelnuovo
- 1 Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
| | - Simona Costanzo
- 1 Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
| | - Mariarosaria Persichillo
- 1 Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
| | - Amalia De Curtis
- 1 Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
| | - Chiara Cerletti
- 1 Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
| | - Maria Benedetta Donati
- 1 Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
| | - Giovanni de Gaetano
- 1 Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
| | - Licia Iacoviello
- 1 Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy.,2 Department of Medicine and Surgery, Research Centre in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
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Ruiz-Castell M, Kandala NB, Kuemmerle A, Schritz A, Barré J, Delagardelle C, Krippler S, Schmit JC, Stranges S. Hypertension burden in Luxembourg: Individual risk factors and geographic variations, 2013 to 2015 European Health Examination Survey. Medicine (Baltimore) 2016; 95:e4758. [PMID: 27603374 PMCID: PMC5023897 DOI: 10.1097/md.0000000000004758] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 08/04/2016] [Accepted: 08/09/2016] [Indexed: 12/19/2022] Open
Abstract
Hypertension is a modifiable risk factor for cardiovascular disease, but it remains the main cause of death in Luxembourg. We aimed to estimate the current prevalence of hypertension, associated risk factors, and its geographic variation in Luxembourg.Cross-sectional, population-based data on 1497 randomly selected Luxembourg residents aged 25 to 64 years were collected as part of the European Health Examination Survey from 2013 to 2015. Hypertension was defined as systolic/diastolic blood pressure ≥140/90 mm Hg, self-report of a physician diagnosis or on antihypertensive medication. Standard and Bayesian regressions were used to examine associations between hypertension and covariates, and also geographic distribution of hypertension across the country.Nearly 31% of Luxembourg residents were hypertensive, and over 70% of those were either unaware of their condition or not adequately controlled. The likelihood of hypertension was lower in men more physically active (odds ratio [95% credible region] 0.6 [0.4, 0.9]) and consuming alcohol daily (0.3 [0.1, 0.8]), and higher in men with a poor health perception (1.6 [1.0, 2.7]) and in women experiencing depressive symptoms (1.8 [1.3, 2.7]). There were geographic variations in hypertension prevalence across cantons and municipalities. The highest odds ratio was observed in the most industrialized region (South-West) (1.2 [0.9, 1.6]) with a positive effect at 90% credible region.In Luxembourg, the vast majority of people with hypertension are either unaware of their condition or not adequately controlled, which constitutes a major, neglected public health challenge. There are geographic variations in hypertension prevalence in Luxembourg, hence the role of individual and regional risk factors along with public health initiatives to reduce disease burden should be considered.
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Affiliation(s)
- Maria Ruiz-Castell
- Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Ngianga-Bakwin Kandala
- Health Economics and Evidence Synthesis Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Mathematics and Information sciences, Faculty of Engineering and Environment, Northumbria University, Newcastle upon Tyne, UK
| | - Andrea Kuemmerle
- Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Anna Schritz
- Competence Center in Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Jessica Barré
- Competence Center in Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
| | | | - Serge Krippler
- Lycée technique pour professions de santé, Luxembourg
- Directorate of Health, Luxembourg
| | | | - Saverio Stranges
- Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
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