Hypertension and quality of life: The disease, the treatment or a combination of both

Patients often fail to recognize essential hypertension as a disease until it is identified as such by a physician. Thus it is commonly believed that the side effects of the medication are primarily responsible for their feeling ill, rather than the effects of the disease itself. Our study compares the Quality of Life (QoL) of normotensives and hypertensives and inquires into the effects of the disease, as well as those of antihypertensive medication. The study compared 368 outpatient male hypertensives with 155 male normotensives, matched for age and level of education, using various QoL indicators and other measures at the beginning of a one-year, controlled clinical trial. The results showed that the hypertensives view their life events as more severe and less desirable than do the normotensives: they exhibit higher depression scores, more semantic memory problems and less satisfactory sex lives; they feel less fit physically, less in control of their lives, more tense and score lower on a hardiness scale in comparison with their normotensive counterparts. To assess the influence of previous antihypertensive treatment, we divided the hypertensives into those who had undergone previous pharmacological treatment and those not previously treated. The results showed that impairment of QoL is related to age, disease and previous treatment. These findings suggest either that patients became committed to this "sick role" long before our inquiry, or that hypertension is a disease in which patients report lower levels of QoL in some aspects (compared with those of normotensives) even if not receiving medication.