Analysis on quality of life and influencing factors of hypertensive patients in Tianjin
Objective To understand the life quality and influencing factors of hypertensive patients in Tianjin,and provide the basis for clinical decision-making to improve the quality of life of hypertensive patients.Methods The study was based on the"Early Screening and Comprehensive Intervention Project for High-risk Groups for Cardiovascular Disease",the included 65 400 people screened for cardiovascular high-risk screening in 13 community health service centers and primary hospitals in Tianjin from 2017 to 2023 were selected as the subjects.The life quality was evaluated with EQ-5D-3L scale,which included two parts:EQ-5D describing system(health utility values)and EQ-5D Visual Analogue Scale(VAS).Analysis of variance test and x2 test were used to analyze the data,the used software was SAS 9.2 software and Stata 15.0 software.Tobit regression analysis for health utility values and OLS regression analysis for VAS scores were used to analyze the factors influencing the quality of life.The ordered multi-classification logistic stepwise regression was used to analyze the influencing factors of five dimensions.Results Among 65 400 subjects,non-hypertensive patients were 40 044 cases(61.23％),hypertensive patients were 25 356 cases(38.77％).The health utility score and VAS score of non-hypertensive patients were 0.98±0.06 and 82.63±10.07,respectively;the health utility score and VAS score of hypertensive patients were 0.96±0.08 and 78.25±11.87,respectively.The health utility score and VAS score of hypertensive patients were significantly higher than those of non-hypertensive patients(P＜0.05).The proportion of difficulties(including some difficulties and extreme difficulties)in five dimensions of EQ-5D describing system among hypertensive patients was significantly higher than that of non-hypertensive patients(P＜0.05).The results of the Tobit regression analysis showed that the health utility values of elderly(β=-0.003,95％CI:-0.004--0.003),female(β=-0.058,95％CI:-0.069--0.048),annual income＞50 000 yuan(β=-0.016,95％CI:-0.027--0.006),dyslipidemia(β=-0.060,95％CI:-0.073--0.047),obesity(β=-0.014,95％CI:-0.022--0.005),diabetes mellitus(β=-0.021,95％CI:-0.031--0.011),cardiovasculardisease(β=-0.091,95％CI:-0.102--0.080)were lower;the health utility values of farmers(β=0.018,95％CI:0.007-0.029)and alcohol drinkers(β=0.015,95％CI:0.001-0.029)were higher.The results of the OLS regression analysis showed that VAS scores of elderly(β=-0.058,95％CI:-0.076--0.040),female(β=-0.824,95％CI:-1.165--0.483),high level of education(β=-0.933,95％CI:-1.261--0.604),annual income＞50 000 yuan(β=-0.373,95％CI:-0.724--0.022),smoking(β=-0.484,95％CI:-0.869--0.098),dyslipidemia(β=-3.337,95％CI:-3.788--2.885),obesity(β=-0.639,95％CI:-0.933--0.344),diabetes(β=-2.716,95％CI:-3.052--2.380),CVD(β=-4.911,95％CI:-5.286--4.536)and chronic obstructive pulmonary disease(β=-3.441,95％CI:-6.576--0.306)were lower;the VAS scores of co-residence(β=0.900,95％CI:0.365-1.436),farmers(β=1.220,95％CI:0.861-1.579)were higher.The results of the ordered multi-classification logistic stepwise regression analysis showed that CVD had significant impact on mobility(OR=3.545,95％CI:3.124-4.023),self-care(OR=5.872,95％CI:4.441-7.763),daily activity dimension(OR=5.515,95％CI:4.531-6.713);female patients were more likely to present the pain/discomfort(OR=1.637,95％CI:1.526-1.757)and anxiety/depression(OR=1.983,95％CI:1.766-2.227).Conclusion The life quality of hypertensive patients is poor,and pain/discomfort dimension problems are significant.It should pay attention to the elderly,female and patients with complication.
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