QUALITY OF LIFE OF PERSONS WITH HYPERTENSION AND RELATIONSHIP WITH THE STATUS OF TREATMENT: RESULTS OF CROSS-SECTIONAL EXAMINATION EMPLOYEES OF DNIPRO EDUCATIONAL INSTITUTIONS
Aim. To assess the quality of life of patients with hypertension, the relationship with the effectiveness of treatment, and their participation (autonomy) in the treatment process among employees of educational institutions in Dnipro.
Materials and methods. Following the initiative of the International Society of Hypertension within the program «May Measurement Month, » a group of staff and students at Dnipro State Medical University made a cross-sectional study of blood pressure (BP) among 131 adults (over 18 years) employed by schools and universities of Dnipro region, especially teachers. Each participant had three BP measurements and completed a demographic, lifestyle, and environmental factors questionnaire. The general questionnaire «SF-36» (Health Status Survey-36) was used for the study of the quality of life (QOL). Hypertension (HTN) was defined as a systolic BP of ≥140 mm Hg or a diastolic BP of ≥90 mm Hg based on the mean of the second and third BP recordings. Those taking antihypertensive medications were also assumed to have HTN and were aware of their condition.
Results. A survey supplemented by instrumental examinations revealed that HTN was detected in 84 (64.1 %) persons (95 % CI 55.3 - 72.3). Of those surveyed, 59 received appropriate antihypertensive treatment, corresponding to 70.2 % of detected cases of HTN. Of those who received antihypertensive medications, 39 (66.1 %) had controlled BP, which represents 46.4% of all patients with HTN included in the study. From the number of persons with known HTN (n=64), only 39 (60.9 %) reached the target values of BP. 33.9 % of patients receiving antihypertensive treatment did not achieve adequate control of HTN, which may indicate the ineffectiveness of the treatment. Of those surveyed, 59 (45.0 %) (95 % CI 36.3 - 54.0) received appropriate AHT, which corresponds to 70.2 % of detected cases of HTN. From the number of people with known HTN (n=64), only 39 (60.9 %) reached the target values of BP.
Assessment of QOL according to the SF-36 method showed that most respondents assess their health as good (56.1 %) or satisfactory (37.8 %). Educators rated the QOL field of Physical Functioning as the best, Role-Physical, and Social Functioning as the worst. Patients with HTN had a statistically significantly lower value of QOL on the Role-Physical (p=0.004) and Role-Emotional (p=0.026) scales compared with persons without HTN, which indicates the important role of physical and emotional problems in limiting the activity of patients with HTN.
Conclusion. The finding indicates a low propensity of patients to make decisions about their health. More than half of the respondents with high BP were unaware of their condition and did not receive appropriate treatment, while more than a third of patients did not achieve BP control even while taking medication. This justifies the need for a more thorough diagnosis and treatment of HTN involving patients in this process. These results seem to be impacted by a special study cohort representation of the patients-employees of educational institutions.
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