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Measuring quality of life in hypertension

  • Chapter
Quality of Life Assessment: Key Issues in the 1990s

Abstract

The treatment of hypertension is long-term and is directed towards the reduction of mortality and morbidity, especially from stroke and heart disease (CHD). Although treatment undoubtedly reduces strokes, and to a lesser extent CHD events4, there are a variety of unresolved issues. These include what levels of blood pressure should be treated, whether indications for treatment should also include prognostic factors such as age, gender, and the presence of other cardiovascular risk factors, which treatment to use (including non-pharmacological approaches), adverse effects and the monetary costs of treatment. Adverse effects include factors which may affect morbidity, such as elevated blood lipids, uric acid, glucose intolerance, and more diffuse side-effects which impair well-being, and may cause patients to discontinue treatment. In the trial of the European Working Party on High Blood Pressure in the Elderly (EWPHE) it was calculated that in every 1000 patients treated for one year, active treatment (a potassium sparing diuretic combination, plus methyldopa in one third) was associated with an excess over placebo of four cases of gout, 23 of an abnormal serum creatinine, nine of diabetes, 124 with a dry mouth and 71 complaining of diarrhoea13. In this trial there were relatively few withdrawals due to side-effects. In contrast over the 5 years of the Medical Research Council trial, 16% of patients on active treatment had withdrawn owing to side-effects: impotence, lethargy, nausea, dizziness and headache were the major reasons20.

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Authors
  1. Astrid Fletcher
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  2. Christopher Bulpitt
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Editors and Affiliations

  1. Welsh School of Pharmacy, University of Wales College, Cardiff, UK

    Stuart R. Walker (Director of the Centre for Medicines Research, Carshalton, and Honorary Professor) (Director of the Centre for Medicines Research, Carshalton, and Honorary Professor)

  2. University College and Middlesex School of Medicine, London University, London, UK

    Rachel M. Rosser (Professor of Psychiatry and Head of Department) (Professor of Psychiatry and Head of Department)

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© 1993 Springer Science+Business Media Dordrecht

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Fletcher, A., Bulpitt, C. (1993). Measuring quality of life in hypertension. In: Walker, S.R., Rosser, R.M. (eds) Quality of Life Assessment: Key Issues in the 1990s. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-2988-6_18

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  • DOI: https://doi.org/10.1007/978-94-011-2988-6_18

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-5328-0

  • Online ISBN: 978-94-011-2988-6

  • eBook Packages: Springer Book Archive

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