Relationship between symptoms and health-related quality of life in patients treated for hypertension.

STUDY OBJECTIVE To determine the relationship between symptoms and health-related quality of life (HRQOL) in patients receiving drug therapy for hypertension. DESIGN Cross-sectional survey. SETTING Outpatient general medicine and university-based hypertension clinics. PATIENTS All patients prescribed one or more antihypertensive drugs seen during a 6-month period in the clinics. INTERVENTION Data were obtained from a mailed questionnaire and medical records. MEASUREMENTS AND MAIN RESULTS Symptoms were measured by a symptom count and total symptom distress. Two scores derived from the Short Form-36 (SF-36)--the Physical Component Summary (PCS) and the Mental Component Summary (MCS)--were used to assess HRQOL. Responses were received from 125 of 220 patients (56.8%). Mean +/- SD values were 8.8 +/- 7.8 for symptom count, 31.6 +/- 46.2 for total symptom distress, 48.7 +/- 9.3 for PCS, and 51.6 +/- 10.1 for MCS. Higher symptom counts and symptom distress scores were strongly associated with lower HRQOL scores in multivariate models, with standardized coefficients from -0.62 to -0.41. These were greater in magnitude than any other predictor, including demographic information (age, sex, race, education level, income), disease variables (blood pressure, years of hypertension), and drug treatment (number of antihypertensive drugs and duration of regimen). Model-adjusted R2 values were 0.22-0.41. CONCLUSION Symptoms have a greater impact on HRQOL than patient characteristics, blood pressure, or drug-related factors. Among patients receiving drug therapy for hypertension, detailed review of symptoms may yield important information for assessing and improving HRQOL.