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Quality of Life, Drugs and Diet in Hypertensive Patients

  • H. G. Kirpizidis
Reference work entry

Abstract:

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.

Keywords

Reduce Blood Pressure Antihypertensive Treatment Mediterranean Diet Sodium Intake Vegetable Diet 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:

ACE

angiotensin-converting enzyme

AT II

angiotensin II

B

beta

CCNW

Campbell’s Center for Nutrition and Wellness Plan

DASH

dietary approaches to stop hypertension

GWBI

General Well Being Index

HOT

hypertension optimal treatment

MLP

 Mediterranean Lifestyle Program

MMSE

mini mental state examination

MRC

Medical Research Council

NHLBI

National Heart Lung and Blood Institute

QOL

quality of life

SF-12

12-item Short-Form General Health Survey

SF-36

36-item Short-Form General Health Survey

SSA-P

Subjective Symptoms Assessment Profile

SCOPE

Study on Cognition and Prognosis in the Elderly

SHEP

Systolic Hypertension in the Elderly Program

Syst-Eur

Systolic Hypertension in Europe

TAIM

trial of  antihypertensives, interventions and management

TOMHS

Treatment of Mild Hypertension Study Research Group

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Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • H. G. Kirpizidis

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