Health-Related Quality Of Life Among Urban And Rural Hypertensives—A Comparative Research In Shandong Province

BackgroundWe are living in a rapidly developing society.One of the obvious changes is that non-communicable diseases(NCDs)rank first in the list of the causes of death instead of infectious diseases.Being a typical NCD,hypertension is one of the significant related factors of cardiovascular disease,and it has a bad effect on human health and life expectancy.Hypertension is a "invisible killer" which rarely causes symptoms,however,long-term hypertension will lead to heart disease,stroke,kidney failure,premature death and physical disability.It will have adverse effect on hypertensives’health badly by causing damages physically and mentally,and shortening their life expectancy and extending their hypertension duration and disability adjusted life year(DALY).There are plenty of hypertensives in China.And in view of the urban-rural structure in China,it is of vital importance to analyze the related factors of health-related quality of life(HRQoL)among hypertensives and make a comparative research between urban and rural hypertensives.ObjectiveTo analyze the difference of HRQoL between urban hypertensives and rural hypertnesives,explore the associated factors related to HRQoL of urban hypertensives and rural hypertensives respectively and provide relevant advises to improve HRQoL of hypertensives.MethodsWe draw 3911 hypertensives in Shandong province with stratified cluster sampling.And face-to-face interview was used to collect data.We entry data by Epidata and analyze data by SPSS.Firstly,we describe data to understand the distribution of urban and rural hypertensives and the distribution of five dimensions of EQ-5D.To explore the related factors of HRQoL of urban and rural hypertensives,t-test,ANOVA,and liner regression were employed to conduct univariate analysis,and then,multiliner regression was used to make multivariate analysis.Finally,multi-logistic regression was conducted to analyze factors related to each dimension of HRQoL of rural and urban hypertensives.ResultsThere exists strong difference of HRQoL between urban hypertensives and rural hypertensives(P<0.001).The HRQoL of urban hypertensives(M=0.88)is better than rural hypertensives(M=0.84).Regular exercise(P<0.001),self-rated health(P<0.001),K10(P<0.001),hypertension knowledge(P=0.037)and complications(P=0.003)were proved associated with HRQoL among urban hypertensives;in the meanwhile,gender(P<0.001),age(P<0.001),occupation(P=0.009),family income(P=0.007),economic burden(P=0.002),regular drinking(P=0.005),regular exercise(P<0.001),self-rated health(P<0.001),BMI(P=0.012),K10(P<0.001),hypertension knowledge(P=0.003),hypertension duration(P=0.049),regular blood pressure measurement(P<0.001),and hypertension stage(P=0.003)were found to be related to HRQoL among rural hypertensives.ConclusionThere exists strong association between HRQoL and residence place(urban and rural).Measures are expected to be taken to improve urban and rural hypertension patients HRQoL respectively.For urban and rural hypertensives,they are as expected to:1)Propaganda hypertension knowledge and raise their health awareness;2)Improve hypertension patients’ mental health to prevent illness worsening;3)Encourage hypertensives to exercise to improve their confidence and physical condition.Urban hypertensives should make efforts to prevent complications especially.Measures aiming to improve rural hypertensives HRQoL include:1)Draw attention on vulnerable groups,especially hypertension group and people who were overweight and obesity,old,men and who have severe illness condition;2)Perfect the medical insurance policy and medical aid policy to ease the economic burden of hypertension patients;3)Measure blood pressure(BP)regularly and slow disease progression.Regular BP measurement has an advantage of monitoring the progress of illness to prevent complications and improve patients’ HRQoL.