الفهرس 
Definition of hypertensionOnly 14 pages are availabe for public view
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Abstract
Hypertension is a condition with a tremendous economic and public health impact which contributes to disability, health-care costs and mortality. It is the first leading global risk for mortality, as it is responsible for 13% of global deaths. Its global prevalence in adults aged 18 years and over was around 22% in 2014.
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC-7) defined hypertension as SBP ≥ 140 mm Hg and/or DBP ≥90 mm Hg. A SBP of 120–139mmHg or a DBP of 80–89 mmHg is defined as prehypertension.
Hypertension is one of the chronic diseases that affect the HRQOL of patients suffering from it. As advances in medical science and technology and new and more aggressive treatments succeeded in increasing number and survival rates of people living with chronic diseases and disabilities, attention increasingly turned towards the HRQOL of patients rather than longevity alone.
HRQOL is emerging as an important indicator to assess the physical psychological and social impact of the disease on affected individuals and to evaluate treatment outcome, and its improvement has becom The assessment of HRQL is a particularly interesting endeavor in patients with hypertension because it can be affected by hypertension itself and by side effects of treatment. Thus hypertension may have an impaction on the patient’s physical, psychological and social functioning that may alter their HRQOL.
The Objective of the current study is to: Measure the HRQOL among hypertensive patients attending outpatient clinics at Ain Shams university hospital (Internal medicine hospital), and to determine the sociodemographic characteristics and clinical factors that may affect the HRQOL of those patients.
This study was conducted in the outpatient clinics in the Ain-Shams University hospital, as case-control study. A total of 300 subjects (150cases and 150 controls), of both genders and older than 18 years, were included in the study.
Socio-demographic and clinical data of participants were collected by structured questionnaire; and HRQOL was assessed by using an Arabic version of two questionnaires - WHOQOL-BREF and COOP\WONCA scale.
Blood pressure was measured using a mercury sphygmomanometer. Also weight and height were measured and BMI was calculated.
Study findings showed that the results of Pearson‘s Correlation Coefficients and Cronbach’s alpha coefficients tests have confirmed that the Arabic version of WHOQOLBREF is a valid and reliable instrument to measure HRQOL among Egyptian hypertensive patients.
Hypertensive patients had lower mean scores in all domains of WHOQOL-BREF than normotensive individuals, with statistically significant difference in general, physical and psychological domains. Physical domain was the most affected, while psychological domain was the least affected.
The linear regression analysis showed that predictors of the lower score of physical domain are primarily disease related conditions (the increased number of comorbid conditions, the higher body mass index, the increased number of accompanying symptoms) besides, the advancing of age, and female gender. While, psychological domain is essentially negatively affected by sociodemographic factors (female gender, lower income level, and unemployment) and, to a lesser extent, by the longer duration of hypertension. Lower income level and longer duration of hypertension are negatively correlated with the environmental and social domains respectively.
Nearly similar results about affected domain were obtained by COOP\WONCA chart, except in that COOP\WONCA scale failed to detect the difference in feeling domain (which is comparable to psychological domain in WHOQOL-BREF) between cases and controls(2.69 ± 1.22 vs 2.53 ± 1.28, p=.239). This difference appeared obviously by WHOQOL-BREF (55.36 ± 16.93 vs 61.39±17.07, p=.002).Both WHOQOL-BREF and COOP/WONCA scale were inversely and significantly correlated with each other. This confirmed that COOP/WONCA could be a useful instrument for assessing HRQOL in hypertensive patients.
It is concluded that hypertension markedly impairs HRQOL of patients suffering from it; this impairment is more in physical domain while less pronounced in psychological domain. The linear regression analysis showed that age, female gender, BMI, unemployment, income, duration of hypertension, number of symptoms and number of co-morbidities are important predictors of HRQOL in hypertensive patients. COOP/WONCA could be a useful instrument for assessing HRQOL in hypertensive patients.
Recommendations include: Health professionals should pay more attention to patients‘ quality of life, mainly in the early treatment of hypertensive patients, at a point where improving the HRQOL is still possible. Prevention, early diagnosis and effective treatment of chronic conditions are essential to preserve the quality of life. Groups that might have a higher priority are women, those with comorbid conditions, over weight/obese, those with longer disease duration, and those who are socially deprived.