Hypertension Impact on Health-Related Quality of Life: A Cross-Sectional Survey among Middle-Aged Adults in Chongqing, China

Hypertension, depression, and health-related quality of life among hospitalized patients in Afghanistan

In recent decades, hypertension has become the foremost risk factor for disability-adjusted life years (DALYs). The present study investigated the relationship between quality of life, depression, and hypertension among hospitalized patients in Afghanistan. A cross-sectional survey was administered from September 3, 2022, to February 2, 2023, in the Herat and Mazar-e-Sharif provinces of Afghanistan (N = 2059). The prevalence of depression symptoms was 65.8%, and hypertension was 20.9%. Multiple regression analysis indicated that moderate physical functioning, poor role-physical, higher bodily pain, poor general health, poor social functioning, lower role-emotional, and poor mental health significantly predicted depression. Multiple regression analysis indicated that moderate quality of life, poor physical functioning, higher bodily pain, lower energy/fatigue, and depression significantly predicted hypertension. The findings of the present study offer valuable insights for healthcare providers, policymakers, and researchers in developing targeted interventions and policies to enhance the well-being of individuals facing the challenges of depression and hypertension. The prevalence of hypertension and depression was high among patients in the Herat and Mazar-e-Sharif provinces of Afghanistan. Patients with hypertension had poor mental and physical quality of life. Hospitals should therefore implement regular screening for depression and offer psychological counseling for vulnerable patients with hypertension.

A prospective longitudinal approach to examine the association between social position in childhood, adolescence, and adulthood with the control of hypertension during adulthood

Introduction

Hypertension is one of the main concerns in public health, since it is related with increased morbidity, and potential years of life lost in addition to loss of quality of life. This study aimed to assess: (1) the distribution of indicators of life course SEP in a cohort of Colombian patients with hypertension and (2) to assess the association of life course SEP and control of hypertension among this cohort of patients.

Methods

Data were obtained using the baseline survey of 258 patients from the Social Determinants and Inequities in the Control of Blood Hypertension Program (ProDSICHA). Mother occupation and housing conditions were measured with the Event History Calendar. Mother educational level was measured with the questionnaire developed by the Project on Ethnicity and Race in Latin America (PERLA). Socioeconomic position during adulthood was measured using education, occupation, and income level based in the MacArthur Network.

Results

The group with a higher lifelong social position and the group of lower lifelong social position showed better control of hypertension (OR = 1.21; p <0.05; OR = 1.33; p < .05, respectively) compared to those whose social position throughout life varied the most. No statistical differences were found in the relations between single lifetime social position variables, and hypertension control in the three time points analyzed.

Discussion

These findings warrant further research to deeper our understanding on the role of a multidimensional and cumulative approach of social position in hypertension control.

Health-related quality of life of young academics: A cross-sectional survey of universities in Wuhan, China

Objective

This study aimed to assess the health-related quality of life (HRQoL) of young academics in Wuhan, China, and its determinants.

Methods

A multistage stratified cluster sampling strategy was employed to recruit study participants (young academics &lt;40 years old) from 12 universities in Wuhan. A total of 301 respondents returned a self-complete questionnaire that contained the EQ-5D-5L. Multivariate linear and Tobit regression models were established to determine the sociodemographic and job predictors of the visual analogue scale (VAS) score and the EQ-5D utility index, respectively.

Results

The study participants reported a mean VAS value of 79.42 (SD = 10.51) and a mean EQ-5D utility index of 0.915 (SD = 0.090). Anxiety/depression was the most frequently reported problem (65.12%), followed by pain/discomfort (43.52%). Transitioning towards a full professorship in national key universities (p &lt; 0.001), lower income (p &lt; 0.05) and too much pressure for academic promotion (p &lt; 0.001) were significant predictors of lower HRQoL; whereas, maintaining routines in physical activities (p &lt; 0.001), sleep (p &lt; 0.001) and meals (p &lt; 0.001), a good relationship with colleagues and family members (p &lt; 0.001), and social activities (p &lt; 0.01) were significant predictors of higher HRQoL.

Conclusion

Low HRQoL of young academics in China is evident, as indicated by the 7.08 and 0.049 gap in VAS and utility index, respectively, compared to the general population at the same age. Work and career pressures are associated with the low HRQoL of young academics. The findings of this study highlight the importance of work-life balance in promoting HRQoL of young academics in universities in China.

The Effect of Continuous Care Model on Blood Pressure and Quality of Life in Patients with Hypertension: A Randomized Clinical Trial

Introduction: Hypertension is one of the most common diseases in all populations. Since people with hypertension have a lower quality of life (QoL) compared to healthy people, it is necessary to follow up these patients according to their conditions. This study aimed to investigate the impact of a continuous care model on blood pressure and QoL in hypertensive patients. Methods: Using a random sampling method, this randomized clinical trial (RCT) included 66 patients with hypertension referring to the clinic of Shahid Madani hospital in Tabriz, Iran in 2019. Data collection tools in this research were demographic information questionnaire, sphygmomanometer control device and stethoscope and Quality of Life questionnaire (The Short Form Health Survey-12, SF-12). The patients were randomly assigned into two groups of control and experimental. After the pre-test, the patients’ needs in the experimental group were assessed and the problems were resolved. Then, the post-test was performed one month and two months after the intervention. Data analysis was performed using SPSS software version 13. Results: After the intervention, there was a significant difference in the QoL score and blood pressure in the experimental group. However, this difference was not significant in the control group. Conclusion: Results indicated that using a follow-up care model had a positive effect on the blood pressure and QoL of patients with hypertension. It is recommended that further studies examine the impact of the integrated care model on QoL in other chronic diseases.

Association among high blood pressure health literacy, social support and health-related quality of life among a community population with hypertension: a community-based cross-sectional study in China

OBJECTIVES

The prevalence of hypertension is increasing worldwide. Hypertensive patients in China have limited high blood pressure health literacy (HBP-HL) and social support (SS), which may have an impact on health-related quality of life (HRQoL) and lead to poorer clinical outcomes. However, the potential mechanism of HBP-HL, SS and HRQoL remains unclear. The aim of this study was to investigate the association among HBP-HL, SS and HRQoL among community patients with hypertension in China.

DESIGN

A community-based cross-sectional survey.

SETTING

The community health service center in Huzhou, China.

PARTICIPANTS

406 community patients with hypertension were investigated from June to October 2019.

PRIMARY OUTCOME MEASURES

HRQoL was assessed using the Quality of Life Instruments for Chronic Diseases-Hypertension V2.0, HBP-HL was assessed with the HBP-Health Literacy Scale into Chines and SS was assessed with the Social Support Rating Scale.

RESULTS

Compared with moderate level of HRQoL and SS, HBP-HL of community hypertensive patients was significantly deficient. Overall, 93 patients (23.2%) lacked HBP-HL, 308 patients (76.8%) had a medium level of HBP-HL, and none of them had sufficient HBP-HL. Correlation analysis showed that HBP-HL, SS and HRQoL were positively correlated (p<0.01). The significant differences in HRQoL and SS were detected in HBP-HL level (p<0.001). In multiple linear regression models, HRQoL was significantly associated with 'Print HL' and 'Medication Label' of HBP-HL (p<0.05) and all three dimensions of SS (p<0.05). In addition, The bootstrap method was used to examine the indirect effect among variables. The results showed that SS played a mediating role between HBP-HL and HRQoL (p<0.001).

CONCLUSION

There is an association among HBP-HL, SS and HRQoL in community hypertension patients. HBP-HL can directly affect HRQoL, and through SS mediate the HRQoL. Community intervention for hypertension management should consider HBP-HL promotion and social engagement as the breakthrough points to increase the impact on patients' HRQoL.

Internet-based platform for a low-calorie dietary intervention involving prepackaged food for weight loss in overweight and obese individuals in China: protocol for a randomised controlled trial

INTRODUCTION

Obesity is a global health issue that impacts quality of life. A calorie-restricted diet with high-intensity consultation provided via the internet may be an effective way to lose weight. The objective of this study was to assess the effectiveness of a practitioner-guided, mobile internet-based low-energy dietary intervention in overweight and obese populations in China.

METHODS AND ANALYSIS

This open-label randomised controlled trial enrolled 220 overweight and obese adults aged 18-70 years who met the inclusion criteria. Participants were assigned to the control group (n=110) or trial group (n=110). The trial group will be enrolled in the MetaWell programme, a weight loss programme using diet replacement products, wireless scales and a mobile phone app. Participants in the control group will receive paper material containing a sample diet for weight loss. The follow-up period will be 1 year, and measurements will occur at 3, 6 and 12 months. Dual-emission X-ray absorptiometry and abdominal quantitative CT will be performed to estimate the percentage of overall body fat and areas of visceral and subcutaneous fat, alongside several cardiometabolic measurements. The primary outcome of this study is the change in body mas index (BMI) at 6 months after enrolment. A mixed-effects model will be used to compare BMI and body fat changes between the two groups.

ETHICS AND DISSEMINATION

This study was approved by the ethics committee of the Hospital of Chengdu Office of the People's Government of the Tibetan Autonomous Region. Advertisements for recruitment will be sent via official accounts using WeChat. The results will be disseminated via publications in academic journals and our clinic. Our study group will maintain contact with the participants to inform them of the study findings.

TRIAL REGISTRATION NUMBER

ChiCTR1900021630.

Self-management using crude herbs and the health-related quality of life among adult patients with hypertension living in a suburban setting of Malaysia

PURPOSE

To determine the prevalence of crude herbs' use in the self-management of hypertension and the health-related quality of life (HRQOL) in patients with hypertension.

METHODS

This cross-sectional study was performed among patients with hypertension attending a government health clinic. Socio-demographic characteristics, lifestyle modifications, medical history and predictors of crude herbs users were obtained. The diversity of crude herbs used was assessed using a modified international complementary and alternative medicine questionnaire (I-CAM-Q) and the HRQOL was assessed using the SF36 instrument.

RESULTS

Out of the 294 patients recruited, 52.4% were female, 41.5% were Malay and 38.8% were within the 60 to69 age category. The prevalence of crude herbs users was 30.6% and the most common herbs used were pegaga (Centella asiatica), peria (Momordica charantia) and betik (Carica papaya). Using the regression analysis, significantly higher odds of using crude herbs are noted among Malay or Indian patients who have these characteristics: attained secondary education, experienced falls or muscle pain, and had systolic blood pressure of more than 140 mmHg. There was no significant difference in HRQOL domains between the crude herb users and non-users (p>0.05).

CONCLUSION

Besides taking allopathic medications, certain patients with hypertension use crude herbs as a form of self-management. Although patients are adamant about integrating crude herbs as a form of self-management, the effects of doing so have not been properly investigated. This implies that the healthcare staff members need to communicate with the patients regarding the use of crude herbs together with conventional drugs.

Quality of Life and Awareness of Hypertension Among Hypertensive Patients in Saudi Arabia

Background and aim

Hypertension possesses significant public health challenges for both developing and developed economies. Therefore, it is crucial to evaluate the awareness of hypertension and health-related quality of life (HRQoL) among patients with hypertension. This study aims to evaluate the knowledge of hypertension and HRQoL among hypertensive patients.

Materials and methods

A cross-sectional study using an anonymous questionnaire was conducted over a period of 4 months (November 2020 to February 2021) in Riyadh, Kingdom of Saudi Arabia (KSA). This study included 437 questionnaires submitted by the hypertensive population.

Results

A total of 437 participants were included in this study, with 55.4% being males (n=242). The majority (85.1%) were aware of the normal values of blood pressure. Many participants had no problems with mobility, personal care, usual activities, pain or discomfort, and anxiety or depression. Age groups showed a significant association with mobility and usual activities. The knowledge of hypertension was significantly associated with HRQoL.

Conclusion

This study found that majority of the hypertensive patients were aware of the standard values of blood pressure. HRQoL concerning physical functioning and general health is found to be good based on the EuroQol visual analogue scale (EQ VAS) in the hypertensive population who are aware of their condition. This study reported a weak yet significant association between hypertension-related knowledge and HRQoL scores. Several factors can affect the HRQoL of the hypertensive population including gender, education, occupation, and income status.

Socioeconomic position and quality of life among Colombian hypertensive patients: The mediating effect of perceived stress

This study aimed to assess the relationships between socioeconomic position, perceived stress and Health Related Quality of Life (HRQoL) of patients with hypertension. Data were obtained using the baseline survey of 258 patients from the Social Determinants and Inequities in the Control of Blood Hypertension Program (ProDSICHA). HRQoL was measured with SF-8 Health Survey. Socioeconomic position was measured using education, and the MacArthur Scale. Stress was measured with Perceived Stress Scale. A higher educational level was associated with a higher perception of stress (Coeff = 0.78, p = 0.019). Also, a lower position in the community was associated with a higher perception of stress (Coeff = −0.56, p = 0.027). A higher level of perceived stress was associated with a higher level of mental health (Coeff = 0.64, p = 0.000). No statistical differences were found in the relations between socioeconomic position and physical HRQoL. These findings warrant further research to understand the role of socioeconomic position in physical HRQoL.

Gender differences in quality of life, physical activity, and risk of hypertension among sedentary occupation workers

PURPOSE

This study aimed to explore gender differences among sedentary occupation workers with regard to their quality of life (QoL), physical activity, and risk for high blood pressure, and to identify factors associated with QoL.

METHODS

A convenience sample of 2562 employees from randomly selected ten ministries in Kuwait completed self-administered questionnaires. Collected data included employees' socio-demographic characteristics, levels of QoL (using World Health Organization QoL-Brief tool), and physical activity (using the New Zealand Physical Activity Questionnaire Short Form), and anthropometric measures of weight, height, and blood pressure. Multinomial regression analysis, Chi-square, ANOVA, and student's t tests were implemented. A p value of 0.05 was considered significant.

RESULTS

Participants' mean age was 35.3 years. QoL mean scores were total QoL (74.7), physical health (81.1), psychological health (75.4), social relationship (71.1), and environment (70.8). Females showed worse level of QoL, better physical activity, and higher prevalence of hypertension relative to males. Multinomial regression analysis revealed that female gender, low educational attainability, poor income, high job ranks, shorter working years, obesity, physical inactivity, hypertension, or having at least one chronic illness significantly correlated to fair and poor QoL.

CONCLUSION

Sedentary occupation workers reported modest level of QoL and were at high risk of hypertension. Socio-demographic factors, physical activity, and health status were correlated to QoL. Gender differences existed in QoL, physical activity, and risk of hypertension. Improving employees' QoL through adopting strategies to promote healthy lifestyle in work settings should be activated. Further studies are recommended to explore cultural factors that drive gender differences in QoL.

Quality of Life of Patients with Arterial Hypertension

Symptoms of hypertension with accompanying complications result in a significant reduction in patients' quality of life. Effective conduct of prescribed pharmacotherapy supported by a healthy lifestyle allows to achieve satisfactory effects of treatment, which translates into an improvement in the quality of life of patients. The aim of the work was to determine the quality of life of patients with hypertension and the factors affecting it. The study included 100 people with hypertension, who are patients of the department of internal diseases of the hospital in Hajnówka during the period 1.6.2019-1.12.2019. The questionnaire survey, the standardized WHO Quality of Life (WHOQOL)-BREF scale and the Barthel scale were the research tools. The probability p < 0.05 was assumed as the level of statistical significance. The study group consisted of subjects between 30-89 years old. The majority were men and those living in the city. The average BMI (body mass index) of the subjects was 28.4 kg/m². The duration of the disease among those surveyed was on average 7 ± 6.34 years. The highest-rated area of quality of life was the physical field and the lowest social sphere according to the WHOQOL-BREF questionnaire. Patients with hypertension have determined their quality of life at a good or medium level in the physical, psychological, social, and environmental sphere. There are many factors that improve quality of life in all areas. These include following the recommendations on modifiable risk factors.

Social participation is an important health behaviour for health and quality of life among chronically ill older Chinese people

BACKGROUND

Health behaviours (physical activity, maintenance of a healthy diet and not smoking) are known to be beneficial to the health and well-being of chronically ill people. With China's ageing population and increased prevalence of people with chronic diseases, the improvement of unhealthy behaviours in this population has become crucial. Although recent studies have highlighted the importance of social participation for health and quality of life (QoL) among older people, no study to date has included social participation along with more traditional health behaviours. Therefore, this study aimed to identify associations of multiple health behaviours (social participation, physical activity, maintenance of a healthy diet and not smoking) with health and QoL outcomes (including cognitive and physical function) among chronically ill older adults in China.

METHODS

For this nationally representative cross-sectional study, wave 1 data from the World Health Organization's Study on global AGEing and adult health (China) were examined. In total, 6629 community-dwelling older adults (mean age, 64.9 years) with at least one chronic disease were included. Multivariate linear regression analyses were used to evaluate associations of health behaviours with health and QoL outcomes while controlling for background characteristics.

RESULTS

Greater social participation was associated with better QoL [β = 0.127, standard error (SE) = 0.002, p < 0.001], cognitive function (β = 0.154, SE = 0.033, p < 0.001) and physical function (β = - 0.102, SE = 0.008, p < 0.001). Physical activity was associated with better QoL (β = 0.091, SE = 0.015, p < 0.001) and physical function (β = - 0.155, SE = 0.062, p < 0.001). Sufficient fruit and vegetable consumption was associated with better QoL (β = 0.087, SE = 0.015, p < 0.001).

CONCLUSIONS

Our findings suggest that social participation is an important health behaviour for quality of life and cognitive function among chronically ill older people in China. Health promotion programmes should expand their focus to include social participation as a health behaviour, in addition to physical activity, maintenance of a healthy diet and not smoking.

The differences in self-perceptions of aging, health-related quality of life and their association between urban and rural Chinese older hypertensive patients

Background

Most hypertensive clients are elderly, whose health-related quality of life (HRQL) may be associated with self-perceptions of aging (older individuals’ beliefs about their own aging). Meanwhile, culture and health disparities between rural and urban populations are substantial. Whether there are differences in self-perceptions of aging, HRQL, and their association among elderly hypertensive clients in urban and rural areas remains unknown. The objective of this study was to investigate and compare self-perceptions of aging and HRQL and their association among urban and rural older Chinese hypertensive clients.

Methods

A cross-sectional investigation was conducted in 15 urban community clinics and 22 village clinics from Suzhou, China. Older hypertensive adults were invited to complete a self-administered questionnaire addressing socio-demographic and clinical information, HRQL and self-perceptions of aging.

Results

There were 492 urban participants and 537 rural participants included in the analyses. The physical (40.0 ± 12.1 vs. 30.9 ± 8.9, P <  0.001) and mental (51.5 ± 8.3 vs. 46.0 ± 7.8, P <  0.001) HRQL scores of urban participants were all higher than those of rural ones. Urban participants’ scores on dimensions of “timeline cyclical”, “consequences negative”, and “control negative” of self-perceptions of aging questionnaire (APQ) were lower than those of rural participants (P <  0.001, respectively), while the scores on dimensions of “consequences positive” and “control positive” were higher (P <  0.001, respectively). Adjusted multivariate linear regression showed that participants who had worse self-perceptions of aging had poorer HRQL. Some APQ dimensions associated with urban or rural hypertensive elders’ HRQL were different.

Conclusions

Older hypertensive clients in rural areas have poorer self-perceptions of aging and HRQL than those in urban areas. Health care professionals should pay more attention to HRQL and self-perceptions of aging of older hypertensive clients in rural areas.

Effects of Tai Chi exercise on cardiovascular disease risk factors and quality of life in adults with essential hypertension: A meta-analysis

BACKGROUND

Hypertension is the major attributable risk factor for cardiovascular disease. The effect of Tai Chi on essential hypertension (EH) is contentious.

OBJECTIVES

In this study, we investigated the effects of Tai Chi on the risk factors for cardiovascular disease and quality of life in adults with EH.

METHODS

Using data collected from 15 databases up to December 2018, we meta-analyzed randomized controlled trials of the effect of Tai Chi on EH.

RESULTS

Tai Chi exercise was associated with lower systolic blood pressure (SBP) (WMD -12.47, 95%CI -16.00 to -8.94, P < 0.001) and diastolic blood pressure (DBP) (WMD -6.46, 95%CI -8.28 to -4.64, P < 0.001); better quality of life (SMD 0.62, 95% CI 0.35 to 0.90, P < 0.001); lower lipid profiles, including total cholesterol (WMD -0.49, 95% CI -0.62 to -0.37, P < 0.001), triglycerides (WMD -0.49, 95% CI -0.92 to -0.07, P = 0.02), and low-density lipoprotein-cholesterol (LDL-C) (WMD -0.86, 95% CI -1.30 to -0.43, P < 0.001); and lower blood glucose (WMD -0.91, 95% CI -1.59 to -0.23, P = 0.009). Tai Chi had no significant effect on high-density lipoprotein-cholesterol (WMD -0.92, 95% CI -2.21 to -0.37, P = 0.16).

CONCLUSIONS

Tai Chi lowers blood pressure, total cholesterol, triglycerides, LDL-C, and blood glucose and significantly increases the quality of life in adults with EH. There is strong evidence for the short-term efficacy of Tai Chi exercises. Larger well-designed RCTs focused on the long-term effect of Tai Chi exercises and patient adherence are needed.

Health-related quality of life among patients with hypertension: population-based survey using EQ-5D-5L in Hong Kong SAR, China

OBJECTIVES

To evaluate the effect of hypertension and related comorbidities on the health-related quality of life (HRQoL) using EuroQol 5-dimensions instrument with five-level scale (EQ-5D-5L) Hong Kong (HK) version.

DESIGN

Data were analysed by a secondary data analysis based on a cross-sectional study assessing experience on public specialist outpatient service.

SETTING

A representative sample was recruited from 26 specialist outpatient clinics in HK.

PARTICIPANTS

A total of 4528 patients with hypertension aged 18 or above who responded to the survey.

INTERVENTION

EQ-5D-5L HK was applied to assess the HRQoL. The five-dimension descriptive system and the utility index of EQ-5D-5L were treated as the dependent variable in the current study. Regression modelling was applied to estimate the effect of hypertension and related comorbidities on health-related quality of life.

RESULTS

More respondents were women (53.9%), aged ≥65 years old (60.1%), and with primary educational attainment or below (52.3%). A total of 1466 respondents (32.4%) also reported suffering from diabetes, heart disease (20.8%), vision problem (1.7%) and cancer (1.5%). In the ordinal least squares model, utility decreased most when patients reported having physical disability associated with hypertension (beta=-0.395, SE=0.047), and 0.128, 0.064, 0.05 and 0.048 for mental problem, cancer, vision problem and heart problem. In the Tobit model, the utility reduced most for comorbidity of physical disability, and then mental problem, cancer, vision problem, heart problem and diabetes. For first part of two-part model, respondents coliving with mental problem were 10% less likely to report a full health. For the second part of two-part model, the respondents with physical disability had 0.294 lower in utility.

CONCLUSIONS

Respondents with hypertension reported a low EQ-5D utility score. Respondents were women, with a high education, fully employed and living with families reported better HRQoL. There is a significant effect of comorbidity influence on the decreased HRQoL, particularly those with physical disability and mental problem.

Health-Related Quality of Life of Hypertension Patients: A Population-Based Cross-Sectional Study in Chongqing, China

Purpose: Hypertension is a major risk factor for cardiovascular diseases and stroke, and it requires lifelong medication. This study aimed to investigate the factors impacting on Health-Related Quality of Life (HRQoL) among hypertensive patients in Chongqing, China, and to provide evidence-based strategies to improve their HRQoL. Methods: This cross-sectional survey was conducted in Chongqing, China. Of 600 randomly selected patients, 586 patients agreed to participate and 567 patients completed the survey. A SF-36 (Medical Outcomes Study (MOS) Short Form Health Survey questionnaire) that included eight domains: physical functioning, role limitations due to physical problems, body pain, general health, vitality, social function, role limitations due to emotional problems, and mental health was used to measure HRQoL. Linear regressions were used; each domain of HRQoL was measured in the stratification of sex. Results: Self-perceived relatively low economic burden caused by hypertension and regular physical activity had a positive impact on HRQoL (p < 0.05) for both men and women. For women, younger age was associated with higher scores of measuring physical functioning and body pain. Living with more than three family members had a positive impact on domains, including physical functioning. Emotional self-regulation had a positive association with women’s mental health. Alcohol use for men was associated with higher scores in physical and mental health measures, and emotional self-regulation showed some positive impact on general health. Conclusion: Perceived economic burden caused by hypertension was the most common factor impacting on patients’ HRQoL. Female patients were more susceptible when compared to male patients. Health intervention strategies need to be further explored and adapted to the context of improving HRQoL for patients who suffer from hypertension and other chronic non-communicable diseases.

Health related quality of life (HRQOL) among low socioeconomic population in Malaysia

Background

The rapid growth of economy and increasing cost of living in Malaysia have given significant impact especially to the lowest household income population. The main objective of this study was to determine risk factors for low quality of life (QOL) and poor health status of this population.

Methods

This was a cross sectional study design. A total of 347 respondents from low household income groups, including persons with disability and Orang Asli were recruited from E-kasih. A semi-guided self-administered questionnaire was used. QOL measured by EQ. 5D utility value and health status measured by visual analogue score (VAS). Descriptive statistic, bivariate Chi-square analysis and binary logistic regression were conducted to determine factors influencing low QOL and poor health status.

Results

Majority of the respondents were Malay, female (61%), 63% were married, 60% were employed and 46% with total household income of less than 1 thousand Ringgit Malaysia. 70% of them were not having any chronic medical problems. Factors that associated with low QOL were male, single, low household income, and present chronic medical illness, while poor health status associated with female, lower education level and present chronic medical illness. Logistic regression analysis has showed that determinants of low QOL was present chronic illness [AOR 4.15 95%CI (2.42, 7.13)], while determinants for poor health status were; female [AOR 1.94 95%CI (1.09,3.44)], lower education [AOR 3.07 95%CI (1.28,7.34)] and present chronic illness [AOR 2.53 95%CI (1.39,4.61)].

Conclusion

Low socioeconomic population defined as low total household income in this study. Low QOL of this population determined by present chronic illness, while poor health status determined by gender, education level and chronic medical illness.

Health-Related Quality of Life of People with Self-Reported Hypertension: A National Cross-Sectional Survey in China

This study aimed to determine the health-related quality of life (HRQoL) of people with self-reported diagnosed hypertension and its determinants in China. Data was obtained from the 5th National Health Services Survey. The HRQoL of the respondents who were 15 years or older was assessed with the EQ-5D-3L utility index and visual analogue scale (VAS), and compared between those with (n = 30,063) and without (n = 158,657) self-reported hypertension. Multivariate logistic regression, Tobit regression, and linear regression models were established to identify predictors of HRQoL. A difference of half standard deviation was deemed as minimal clinically important difference (MCID) for the utility index (0.03). The respondents with self-reported hypertension were more likely to report problems in the five dimensions (Adjusted Odds Ratio = 1.43–1.70) of the EQ-5D-3L, resulting in a significant lower utility index (β = −0.04) and VAS scores (β = −3.22) compared with those without self-reported hypertension, and the difference of the utility index exceeded MCID. In the respondents with self-reported hypertension, higher utility index and VAS scores were found in those who were female, younger, married, employed, smoking, drinking, exercising regularly, absent from comorbidity, resided in the eastern developed region, had normal body mass index, higher levels of education, and income. Hypertension management programs were associated with higher utility index (β = 0.01) and VAS scores (β = 1.02). Overall, hypertension is associated with lower HRQoL. Higher socioeconomic status and participation in management programs for chronic conditions are independent predictors of higher HRQoL of hypertensive people. This study provides a national representative estimate on the HRQoL of hypertensive people in China, which can be used for calculating the burden of hypertension.

Health-related quality of life of hypertension in China: a systematic review and meta-analysis

AIMS

Many observational studies have shown a lower health-related quality of life (HRQOL) of hypertension patients. This study aimed to summarize the association between hypertension and HRQOL in the Chinese population.

METHODS

We systematically searched the observational studies in the following databases: Medline, PubMed, Embase, Science Citation Index, Chinese National Knowledge Infrastructure, VIP and WanFang Data from 1 January 1990 to 1 October 2017.

RESULTS

A total of 33 studies were included in this systematic review. Twenty-one of them presented worse quality of life in hypertensive individuals. The meta-analysis showed lower scores in hypertensive individuals for the eight domains and physical components (-4.93; 95% confidence interval -8.40 to -1.47), and no statistical difference in mental components (-1.62; 95% confidence interval -4.26 to 1.02).

CONCLUSION

Among Chinese patients, HRQOL of hypertensive patients is worse than that of normotensive individuals. These data suggest that maintenance of normotension offers benefits on patient-centered outcomes, in addition to other well established cardiovascular benefits.

Health-Promoting Lifestyle: A Considerable Contributing Factor to Quality of Life in Patients With Hypertension

Aim: Investigating the relationship between health promoting behaviors and quality of life in patients with hypertension. Methods: In this cross-sectional study, health-promoting behaviors and quality of life in patients with hypertension were assessed in a cardiology clinic of a university hospital in an urban area of Iran. The sample consisted of 93 patients with hypertension who were recruited using a convenience sampling method. Demographic data, Health Promoting Lifestyle Behaviors Profile (HPLP II) and World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaires were used to gather data. Data were analyzed using SPSS software version 21. Results: The mean score of health promoting behaviors was moderate (2.51 ± 0.47) with highest and lowest scores in nutritional (2.80 ± 0.52) and physical activity (1.78 ± 0.62) dimension, respectively. There was a statistically significant relationship between health-promoting behaviors and quality of life. The relationship between health-promoting behaviors and quality of life had the highest power in psychological health dimension (β = 5.353, P < .001) and lowest power in the environmental dimension (β = 0.365, P < .001). Conclusion: Improving quality of life of patients requires paying attention to educational interventions for creating changes in the lifestyle to improve all aspects of quality of life.

Sleep Quality and Related Psychosocial Variables Among Renal Transplant Patients

BACKGROUND

Several studies have examined sleep quality in the post renal transplant population of China, but few studies have actually confirmed the related psychosocial variables of sleep quality in renal transplant recipients with home care.

OBJECTIVES

This study investigates sleep quality and its related psychosocial variables among renal transplant patients.

METHODS

This is a cross-sectional study using a convenient sampling approach. Self-report questionnaires were applied to 485 renal transplant patients. All participants completed the General Data Questionnaire, the Pittsburgh Sleep Quality Index (PSQI), the Self-Rating Depression Scale, the Three-Dimensional Inventory of Character Strengths, and the Flourishing Scale.

RESULTS

A total of 438 valid questionnaires were included in the analysis. The global PSQI score was 5.86 (SD, 3.20), significantly lower than the norm; 128 (29.2%) recipients were classified as having poor sleep quality (global PSQI > 7). In the component score of PSQI, sleep onset latency was the highest; the others from high to low are sleep disturbance, daytime dysfunction, subjective sleep quality, sleep efficiency, sleep duration, and use of hypnotic medication. A total of 19.6% reported sleeping fewer than 6 hours a night, 64.8% reported that they had to get up to use the bathroom, and 50.0% woke up in the middle of the night or early morning at least 1 night per week in the past month. Significant differences in the PSQI scores were observed in renal transplant patients of different sex, age, residence, career, length of post-renal transplant period, comorbidity, kidney function, and depressive symptoms (P < .05). The PSQI scores were positively correlated with depression (Self-Rating Depression Scale) (P < .01) but negatively correlated with inquisitiveness (Three-Dimensional Inventory of Character Strengths-inquisitiveness) and psychological well-being (Flourishing Scale) (P < .01).

CONCLUSION

The sleep quality of renal transplant patients was lower than that of the general population. Character strengths and well-being can increase the level of sleep quality in renal transplant patients. Psychosocial intervention is necessary for improving the sleep quality of renal transplant recipients in China.

Correlations between health-promoting lifestyle and health-related quality of life among elderly people with hypertension in Hengyang, Hunan, China

Hypertension is considered as an important public health problem in developed and developing countries. The disease is closely associated with health-promoting lifestyle (HPL), and it seems that HPL plays an important role in improving health-related quality of life (HRQOL). This cross-sectional study is to investigate the effects of health-promoting lifestyle (HPL) on health-related quality of life in elderly people with hypertension from a community health service center in Hengyang, Hunan, PR China.Totally 530 elderly patients with hypertension from the community health service center were included in this study, who were asked to fill in a questionnaire (504 patients responded). HPL was assessed by the health-promoting lifestyle profile II (HPLP-II), and HRQOL was measured by the Short Form Health Survey Questionnaire (SF-36).HPL among these elderly people with hypertension was at moderate level (125.02 ± 21), with the highest score for nutrition and the lowest score for health responsibility. Moreover, HRQOL among these elderly hypertensive people was at moderate level (54.36 ± 21.18). Role-emotional domain score was far below average, vitality domain was a little below average, social functioning and general health domains were a little above average, and other domains were far above average. Furthermore, HPL and HRQOL were positively correlated (P < .01). According to the standardized regression coefficients, the influencing factors for HRQOL included (in a descending order) the health responsibility, physical activity, interpersonal relationships, stress management, spiritual growth, and nutrition.HPL and HRQOL were both relatively poor in the elderly people with hypertension from the community health service center. HPL represents an important factor affecting HRQOL of elderly people with hypertension. HRQOL could be improved through promoting HPL (such as health responsibility and physical activity).

The association between self-care and quality of life in hypertensive patients: findings from the Azar cohort study in the North West of Iran

Background: Hypertension affects the quality of life of patients and their caregivers. The aim of this study was to assess the knowledge and self-care behaviors and health-related quality of life (HRQOL) among hypertensive people. Methods: All people aged 35 years and older with hypertension were invited to participate in this study. Information on self-care behavior for hypertension (H-scale), and health-related quality of life (WHOHRQOL-BRFF) were completed by trained interviewer. Data analysis was done using SPSS 16. Results: The median age of hypertensive patients was 62.5(25th to 75th percentile: 55 to 72 years), the correlation between quality of life and overall self-care scores was not significant(r =-0.048, P =0.520). Physical activity was the only significant predictor for quality of life,showing that the quality of life of hypertensive people increased by 3.371 units per day of being physically active in the cohort study (β =0.223, P<0.01). The only significant predictor of quality of life among the elderly was medication use (β =-0.572, P<0.001). Quality of life of participants decreased 3.456 units per day as a result of medication adherence. Conclusion: No association was observed between self-care and HRQOL total score in hypertensive patients in the study. Among the self-care domains, only medication adherence and physical activity had significant association with social health. There was a reverse association between smoking and HRQOL.

Health-Related Quality of Life in Patients with Arthritis: A Cross-Sectional Survey among Middle-Aged Adults in Chongqing, China

Background: Arthritis is a common disease in China, but few studies have been conducted to explore the associated health-related quality of life (HRQoL) and its influencing factors in Chongqing, China. This study aimed to explore the association of arthritis and HRQoL and probe factors affecting HRQoL among arthritis patients. Methods: A cross-sectional survey was conducted in Chongqing, China. A total of 1224 adults were included in the analysis. Medical Outcomes Study Short Form 36 Health Survey (SF-36) was used to measure HRQoL. Multiple linear regression models (stepwise) and covariance analysis models were used to examine the association of arthritis with HRQoL and analyze factors associated with HRQoL among arthritis patients. Results: Participants with arthritis had poorer HRQoL than those without. Among arthritis patients, the female was associated with a poorer state of physical functioning (p < 0.05); unemployed patients had a poorer state of role-physical than employed patients (p < 0.05); low average monthly income was associated with a poorer state of physical functioning (p < 0.01); childhood non-breastfeeding history was associated with a poorer state of social functioning (p < 0.01); average or dissatisfied attitude to current living conditions was associated with a poorer state of vitality and mental health (p < 0.05 for all); moreover, poor or general appetite was associated with a poorer state of role-physical, general health, social functioning, bodily pain, and role-emotional (p < 0.01 for all). Conclusions: Arthritis patients have worse HRQoL than those without in the Chinese population. Female, low socioeconomic status, childhood non-breastfeeding history, average or dissatisfied attitude to current living conditions and poor or general appetite were associated with poorer state of HRQoL among Chinese arthritis patients.

Health-related quality of life among adults with and without hypertension: A population-based survey using EQ-5D in Shandong, China

Previous studies have focused on health-related quality of life (HRQoL) in hypertensive individuals, but few studies have attempted to compare HRQoL between hypertensive and normotensive individuals using the EQ-5D in China. Based on a survey of 3509 adults aged 18 + years, we compared HRQoL between hypertensive and normotensive individuals using a chi-square test, t-test and multi-linear regression model. The results indicated that HRQoL in hypertensive individuals was poorer than that of normotensive individuals in all domains of the EQ-5D and its utility index. In addition, education, complications, household income, and family history of HBP were associated with HRQoL among the hypertensive patients. Factors including age, education, household income, health expenditure, place of residence, and family history of high blood pressure (HBP) were found to be associated with HRQoL in normotensive individuals. Interventions targeting at-risk subgroups, such as modifying existing health insurance schemes to improve them for poor individuals, might be helpful to improve HRQoL.

Increase in the prevalence of hypertension among adults exposed to the Great Chinese Famine during early life

OBJECTIVE

This study aimed to assess the association between exposure to the Great Chinese Famine (1959-1961) during early life and hypertension in adulthood.

METHODS

From July to September 2009, 1224 eligible adults were recruited in a cross-sectional survey using a multi-stage stratified random sampling method in Chongqing China. A questionnaire was used to collect information of hypertension and sociodemographic factors. Participants were categorized as childhood, fetal, and none exposure to famine based on the date of birth.

RESULTS

Of the sample, 12.3% reported having hypertension. The prevalence of hypertension varied by famine status: 11.9% in childhood exposure, 16.1% in fetal exposure, and 10.2% in non-exposure group. After adjusting for sociodemographic and lifestyle factors, compared with non-exposure group, fetal exposure group had an increased likelihood of having hypertension with odds ratio of 1.79 (95%CI 1.13-2.84). Although there was no significant gender and famine interaction, the positive association between famine exposure and hypertension was stronger among women than men.

CONCLUSION

Fetal exposure to the Chinese famine may be associated with an increased risk of hypertension in adulthood in women [corrected].

Increase in the prevalence of arthritis in adulthood among adults exposed to Chinese famine of 1959 to 1961 during childhood: A cross-sectional survey

The developmental origins hypothesis postulates that under-nutrition in the early stage of life is associated with an increased risk of disease in adulthood. This study aimed to examine the association of exposure to the Chinese famine of 1959 to 1961 in early life with the risk of arthritis in adulthood.From July to September 2009, the study adopted multistage stratified random sampling cross-sectional survey to recruit 1224 eligible adults in Chongqing. Famine exposure groups were categorized into 3 groups: (1) childhood exposure, (2) fetal exposure, and (3) nonexposure. Self-reported arthritis of physician diagnosis was obtained. A total of 1224 eligible respondents were interviewed, including 299 individuals exposed during childhood, 455 exposed when fetal, and 470 without exposure.The prevalence of arthritis in adulthood among individuals exposed to famine during childhood was significantly higher than those not exposed (17.39% vs 11.28%, odds ratio [OR] = 1.573 with a 95% confidence interval of [CI] [1.020, 2.424]). Persons exposed to famine during the fetal period did not significantly contribute to a higher rate of arthritis in adulthood than those who were not exposed to famine (13.19% vs 11.28%, OR = 1.072, 95% CI = 0.713, 1.613). In addition, education level, the average monthly income, sleep status, and satisfaction of the present living condition were associated with the risk of arthritis in adulthood.Exposure to the Chinese famine during childhood may be associated with an increased risk of arthritis in adulthood. This study suggests that early life nutrition may have an effect on the risk of arthritis in adulthood.

Associations of Self-Reported Sleep Quality with Circulating Interferon Gamma-Inducible Protein 10, Interleukin 6, and High-Sensitivity C-Reactive Protein in Healthy Menopausal Women

Introduction

Sleep disturbance is very common in menopausal women and poor sleep quality has been linked to systemic inflammation. However, the impact of poor sleep quality on health outcomes of menopausal women remains unclear. This study evaluated the relationships between sleep quality and inflammation in menopausal women.

Participants and design

This cross-sectional study enrolled 281 healthy women aged 45 to 60 years. The Pittsburgh Sleep Quality Index (PSQI) was used to measure quality of sleep. Multiplex assays were used to measure the levels of 9 cytokines in morning fasting plasma samples. Other variables measured in this study included clinical characteristics and high-sensitivity C-reactive protein (hs-CRP).

Setting

The study was performed at a medical center.

Results

The 281 participants comprised 79 (28%) perimenopausal women and 202 (72%) postmenopausal women. Global PSQI scores were positively correlated with plasma hs-CRP levels (P = 0.012) and were marginally associated with interferon gamma-inducible protein-10 (IP10), interleukin 6 (IL6), and macrophage inflammatory protein-1beta (MIP-1β) levels. After adjusting for age, body mass index, menopause duration, and follicle stimulating hormone, multiple linear regression analysis revealed that high PSQI scores and sleep efficiency < 65% were associated with elevated plasma levels of hs-CRP, IP10, and IL6. In addition, sleep duration < 5 hours was associated with high hs-CRP levels.

Conclusion

Our data show that poor sleep quality and low sleep efficiency are associated with elevated levels of circulating inflammatory factors IP10, IL6 and hs-CRP and that short sleep duration is associated with high levels of hs-CRP in menopausal women. These findings provide novel evidence that poor sleep quality is linked to low-grade systemic inflammation in menopausal women.

Body Pain Intensity and Interference in Adults (45-53 Years Old): A Cross-Sectional Survey in Chongqing, China

Culture and national care models matter both in reporting and treatment of pain status. However, most findings on body pain intensity and interference in adults are from Western studies, with little reliable evidence from China. This study aimed to assess body pain intensity and interference and its associations with demographic, socioeconomic characteristics, and health behaviors in adults. A cross-sectional survey was performed to collect data from 1224 adults, who were recruited via multistage stratified random sampling. The SF-36 quality-of-life instrument was used to investigate body pain intensity and interference. Ordinal logistic regression analysis was used in this study. Our results showed that 64.1% of the participants (males: 687; females: 537) reported body pain, and 45.7% of the participants reported body pain interference. Middle-aged respondents who were female, were unmarried/divorced or separated/widowed, had a negative relationship with their family, had poor sleep quality, and were not satisfied with their current living conditions had a higher body pain intensity rating (ordered logistic regression/six-level pain intensity criterion; odds ratios, p < 0.05). Respondents who were unmarried/divorced or separated/widowed, with a low education level, were unemployed, had lower incomes, had a negative relationship with their family, and were not satisfied with their current living conditions had a higher body pain interference rating (ordered logistic regression/five-level pain interference criterion; odds ratios, p < 0.05). In conclusion, an estimated 64.1% of middle-aged adults reported body pain, and 45.7% of middle-aged adults reported body pain interference. These results provide a clue for possible interventions for improving body pain intensity and interference in adults, especially among middle-aged people. These factors should be taken into consideration in the prevention of pain, pain management and treatment planning in order to help relieve the stress of pain among adults.