Chronic Stable Angina Is Associated with Lower Health-Related Quality of Life: Evidence from Chinese Patients

OBJECTIVES To compare health-related quality of life (HRQoL) between patients with stable angina and the general population in China and to examine factors associated with HRQoL among patients with stable angina. METHODS A cross-sectional HRQoL survey of stable angina patients recruited from 4 hospitals (n = 411) and the general population recruited from 3 Physical Examination Centers (n = 549) was conducted from July to December, 2011 in two large cities, Tianjin and Chengdu. HRQoL was assessed using the EQ-5D, EQ-VAS, and SF-6D instruments. The health status specific to patients with stable angina was assessed using the Seattle Angina Questionnaire (SAQ). Information on socio-demographic, clinical, and lifestyle factors were also collected. Nested regressions were performed to explore how these factors were associated with HRQoL in patients with stable angina. RESULTS Compared with the general population (44.2 ± 10 years, 49.9% females), stable angina patients (68.1 ± 12 years, 50.4% females) had significantly lower HRQoL scores in EQ-5D utility index (0.75 ± 0.19 vs. 0.90 ± 0.20, p<0.05), SF-6D utility index (0.68 ± 0.12 vs. 0.85 ± 0.11, p<0.05), and EQ-VAS (71.2 ± 12.3 vs. 83.9 ± 10.9, p<0.05). The differences remained (-0.05 for EQ-5D, -9.27 for EQ-VAS and -0.13 for SF-6D) after controlling for socio-economic characteristics. SAQ scores showed that stable angina patients experienced impaired disease-specific health status, especially in angina stability (40.5 ± 34.6). Nested regressions indicated stable angina-specific health status explained most of the variation in HRQoL, among which disease perception, physical limitation, and angina stability were the strongest predictors. More physical exercise and better sleep were positively related with HRQoL. CONCLUSIONS Compared to the general population, stable angina patients were associated with lower HRQoL and lower health utility scores, which were largely impacted by clinical symptoms. Further studies are needed to characterize the influence of geographic and cultural factors on the variations of health-related utility in stable angina patients.