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Health-related quality of life and hypertension: a systematic review and meta-analysis of observational studies

Trevisol, Daisson Ja,b; Moreira, Leila Ba; Kerkhoff, Alessandraa; Fuchs, Sandra Ca; Fuchs, Flávio Da,c

doi: 10.1097/HJH.0b013e328340d76f

Objective Most, but not all cross-sectional surveys have identified lower quality of life among patients with hypertension. We summarized the estimates for this association in a systematic review and in a meta-analysis of cross-sectional studies.

Methods Studies that used the Short-Form Health Survey (SF) to compare the quality of life of normotensive and hypertensive individuals were searched in Embase, MEDLINE/PubMed, LILACS, Ovid, ScienceDirect, SciELO and Cochrane databases using ‘hypertension’ and ‘quality of life’ medical subject heading (MeSH) terms and the words ‘health survey, SF-12, SF-36 and their spelling variations (SF12, SF 12, SF36 and SF 36)’. Data extraction was conducted by two researchers. Data were analyzed with MIX 1.7 using random effects model. Results of the meta-analysis were expressed as differences of mean scores between hypertensive and normotensive individuals.

Results Most of the 20 studies selected for the systematic review identified lower quality of life in patients with hypertension, but they were very heterogeneous in regard to selection criteria and comparison groups, limiting their external validity. The meta-analysis identified lower scores in hypertensive patients for physical [−2.43; 95% confidence interval (CI) −4.77 to −0.08] and mental (−1.68; 95% CI −2.14 to −1.23) components. Quality of life was lower in the eight domains of the SF-36: physical and functional functioning, role physical and emotional, bodily pain, general health, vitality and mental health.

Conclusion Quality of life of individuals with hypertension is slightly worse than that of normotensive individuals. The influence of high blood pressure and of the awareness to have hypertension requires further investigation.

aPostgraduate Studies Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

bUniversidade do Sul de Santa Catarina, Tubarão, Santa Catarina, Brazil

cDivision of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil

Received 27 June, 2010

Revised 18 September, 2010

Accepted 21 September, 2010

Correspondence to Dr Flávio Danni Fuchs, MD, Serviço de Cardiologia, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos 2350, 90035-903 Porto Alegre, Rio Grande do Sul, Brazil Tel/fax: +5551 3359 8420; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.