Health-related quality of life in blood pressure control and blood lipid-lowering therapies: results from the CHIEF randomized controlled trial

Hypertens Res. 2019 Oct;42(10):1561-1571. doi: 10.1038/s41440-019-0281-z. Epub 2019 Jun 13.

Abstract

Our study aimed to explore changes in health-related quality of life (HRQoL) during blood pressure control and blood lipid-lowering therapies. We conducted a 2 × 2 factorial-designed randomized controlled trial in 180 clinical centers in China. At baseline, participants were randomly assigned to an amlodipine + amiloride/hydrochlorothiazide group or an amlodipine + telmisartan group for the blood pressure control treatment and to a statin group or a routine intervention group for the blood lipid-lowering treatment. The allocation ratio was 1:1 for both treatments. Follow-up lasted for 4 years. HRQoL was assessed using the EuroQol five dimensions three levels (EQ-5D-3L) questionnaire every year. Of 13,542 hypertensive patients enrolled in the clinical trial, 9885 were eligible for the analysis. The problems for all dimensions of the EQ-5D-3L descriptive system were slight at baseline and were well preserved in the follow-up period. The EuroQol visual analog scale (EQ VAS) score and the EQ-5D-3L index improved over time (Ptrend < 0.001), with improvements similar among interventions but different between patients who reached the treatment targets or not. Decreases in systolic/diastolic blood pressure and low-density lipoprotein cholesterol and increases in high-density lipoprotein cholesterol were independently correlated with increases in the EQ VAS score and the EQ-5D-3L index. In conclusion, HRQoL is associated with blood pressure/lipid levels but not with specific antihypertensive or lipid-lowering interventions. Blood pressure control and blood lipid-lowering therapies should not be denied to Chinese patients in consideration of their negative effects on quality of life.

Keywords: Blood lipid; Blood pressure; EQ-5D; HRQoL.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Blood Pressure / drug effects
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Female
  • Humans
  • Hypertension / blood
  • Hypertension / drug therapy*
  • Hypertension / psychology
  • Hypolipidemic Agents / therapeutic use*
  • Male
  • Middle Aged
  • Quality of Life*
  • Surveys and Questionnaires

Substances

  • Cholesterol, HDL
  • Cholesterol, LDL
  • Hypolipidemic Agents