Handbook of Disease Burdens and Quality of Life Measures pp 2965-2986 | Cite as
Quality of Life, Drugs and Diet in Hypertensive Patients
It is well known that hypertension adversely affects quality of life. Being physically active contributes to both mental and physical health. Hypertensive patients rate lower scores in some of the physical and mental components of specific self-administered questionnaires. The quality of life measurement instruments’ objective is to determine whether this type of measurement could be applied effectively by a large number of physicians with little research experience. Successful use of such an instrument could create future opportunities for the evaluation of the true effectiveness of drugs.
SF-12 and SF-36 questionnaires are reliable and sensitive tools for the evaluation of quality of life dimensions for various populations and diseases. The SF-36 questionnaire yields an 8-scale profile with 36 questions. It is useful in surveys of populations, comparing the general burden of diseases.
The goal of the antihypertensive treatment is not only to lower blood pressure, but to exert a positive effect also, on quality of life. The increase in quality of life-scores with antihypertensive treatment is attributed to the favorable effect on blood pressure, and the less adverse effects of the antihypertensive drugs.
Several large trials evaluated the quality of life effects of antihypertensive treatment in hypertensive patients, demonstrating that treatment had no negative effect on quality of life, or even produced some improvement.
Although no class of antihypertensive drugs presents a superior effect over the others in terms of quality of life, the current impression is that angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers, may offer some advantage, with good tolerability and low withdrawal rate. Calcium channel antagonists have also been associated with a positive effect on quality of life, while less favorable effects have been described with β-adrenoreceptor blockers and diuretics.
Incorporating a heart-healthy diet into lifestyle in hypertensive patients, will help to reduce blood pressure, cholesterol levels, blood sugar level, and body weight.
Numerous studies conducted in the past with several diets, gave inconclusive results on blood pressure lowering, regarding the role of dietary supplements. Reducing dietary sodium seems to play a role in reducing blood pressure. The DASH diet [rich in fruits and vegetables, which are naturally low in sodium] and the Mediterranean diet [rich in monounsaturated fats, present in the olive-oil] are efficacious in lowering blood pressure. The biggest blood pressure reductions were for the DASH diet at the sodium intake of 1,500 mg per day.
DASH-Sodium showed the importance of lowering sodium intake-whatever your eating plan. Randomized control trials indicate that the reduction of sodium intake by 80–100 mmol per day from an initial intake of around 180 mmol per day, reduces blood pressure by an average of 4–6 mmHg.
Little information is available to address whether diet composition can affect quality of life. DASH diet that includes low sodium and low fat dairy products, provide important guidelines for public health policy. The combination of such a diet with antihypertensive agents, especially an angiotensin-converting enzyme inhibitor, or an angiotensin II receptor blocker, is optimal in this field.
KeywordsReduce Blood Pressure Antihypertensive Treatment Mediterranean Diet Sodium Intake Vegetable Diet
List of Abbreviations:
- AT II
Campbell’s Center for Nutrition and Wellness Plan
dietary approaches to stop hypertension
General Well Being Index
hypertension optimal treatment
mini mental state examination
Medical Research Council
National Heart Lung and Blood Institute
quality of life
12-item Short-Form General Health Survey
36-item Short-Form General Health Survey
Subjective Symptoms Assessment Profile
Study on Cognition and Prognosis in the Elderly
Systolic Hypertension in the Elderly Program
Systolic Hypertension in Europe
trial of antihypertensives, interventions and management
Treatment of Mild Hypertension Study Research Group
- Hooper L, Bartlett C, Smith GD, Ebrahim S. (2002). Br Med J. 325(7365): 628.Google Scholar
- Jette DU, Downing J. (1994). Phys. Ther. 4: 521–527.Google Scholar
- Mellen P, Gao S, Vitolins M, Goff D. (2007). American Society of Hypertension. Poster, Chicago, IL, 249.Google Scholar
- MRC working party. (1992). Br Med J. 304: 405–412.Google Scholar
- SHEP Cooperative Research Group. (1991). JAMA. 265: 3255–3264.Google Scholar
- The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and treatment of high blood pressure [JNC 7 Report]. (2003). JAMA. 289(19): 2560–2572.Google Scholar
- Treatment of Mild Hypertension Study Research Group. (1993). JAMA. 270: 713–724.Google Scholar
- Volmer WM, Sacks FM, Ard J, Appel LJ, Bray GA, Simons-Morton DG, Conlin PR, Svetkey LP, Erlinger TP, Moore TJ, Karanja N. (2001). Ann Intern Med. 135: 1019–1028.Google Scholar
- Wassertheil-Smoller S, Blaufox MD, Oberman A, Davis BR, Swencionis C, Knerr MO, Hawkins CM, Langford HG. (1991). Ann Intern Med. 114(8): 695–697.Google Scholar
- Weber MA, Bakris GL, Neutel JM, Davidai G, Giles TD. (2003). J Clin Hypertens. 5(5): 322–329.Google Scholar