Blood pressure for optimal health-related quality of life in hypertensive patients

OBJECTIVE: The optimal blood pressure (BP) in terms of health-related quality of life (HRQoL) in patients treated for hypertension remains unknown. This study aimed to determine BP values associated with optimal HRQoL among younger (<65 years old) and older patients (≥65 years old) treated for hypertension. METHODS: HRQoL was assessed using the 12-Item Short Form Health Survey in 11,498 unselected white patients treated for hypertension for at least 12 months. RESULTS: BP values associated with highest Physical Component Summary (PCS) were similar for older patients and those less than 65 years old (125/80 and 125/75 mmHg, respectively). BP values associated with the highest Mental Component Summary (MCS) scores were slightly higher for older patients (123/80 and 115/75 mmHg, respectively). The scores varied depending on the number of antihypertensive drugs. Compared with patients prescribed monotherapy, SBP associated with the highest PSC scores was increased by 11 mmHg in patients taking two or three drugs, and by 15 mmHg in patients taking at least four drugs. However, DBP values associated with the highest PCS scores and BP values associated with the highest MCS scores showed little difference according to drug regimens. Results of multivariate regression analysis adjusted for BP control revealed that PCS score was more strongly associated with age, presence of multiple comorbidities and duration of antihypertensive therapy, whereas MCS score was more strongly associated with multiple comorbidities and number of antihypertensive drugs. CONCLUSION: BP values associated with optimal HRQoL are similar in younger and older patients treated for hypertension and are within the recommended goals. However, BP values associated with optimal HRQoL increase with the number of antihypertensive drugs, reflecting severity of the disease. Therefore, therapeutic goals should be individualized to prevent HRQoL deterioration.