Health-Related Quality of Life of People with Self-Reported Hypertension: A National Cross-Sectional Survey in China

Abstract

This study aimed to determine the health-related quality of life (HRQoL) of people with self-reported diagnosed hypertension and its determinants in China. Data was obtained from the 5th National Health Services Survey. The HRQoL of the respondents who were 15 years or older was assessed with the EQ-5D-3L utility index and visual analogue scale (VAS), and compared between those with (n = 30,063) and without (n = 158,657) self-reported hypertension. Multivariate logistic regression, Tobit regression, and linear regression models were established to identify predictors of HRQoL. A difference of half standard deviation was deemed as minimal clinically important difference (MCID) for the utility index (0.03). The respondents with self-reported hypertension were more likely to report problems in the five dimensions (Adjusted Odds Ratio = 1.43–1.70) of the EQ-5D-3L, resulting in a significant lower utility index (β = −0.04) and VAS scores (β = −3.22) compared with those without self-reported hypertension, and the difference of the utility index exceeded MCID. In the respondents with self-reported hypertension, higher utility index and VAS scores were found in those who were female, younger, married, employed, smoking, drinking, exercising regularly, absent from comorbidity, resided in the eastern developed region, had normal body mass index, higher levels of education, and income. Hypertension management programs were associated with higher utility index (β = 0.01) and VAS scores (β = 1.02). Overall, hypertension is associated with lower HRQoL. Higher socioeconomic status and participation in management programs for chronic conditions are independent predictors of higher HRQoL of hypertensive people. This study provides a national representative estimate on the HRQoL of hypertensive people in China, which can be used for calculating the burden of hypertension.