Association between comorbidity and health‐related quality of life in a hypertensive population: a hospital‐based study in Bangladesh

Abstract

Background: Hypertension is a known risk factor for several chronic conditions including diabetes and cardiovas- cular diseases. However, little is known about its impact on Health-related quality of life (HRQoL) in the context of

Bangladesh. This study aimed to evaluate the association of hypertension on HRQoL among Bangladeshi patients corresponding to the socio-demographic condition, comorbid conditions, treatment, and health outcomes. Methods: A hospital based cross-sectional study was conducted using a pre-tested structured questionnaire among patients with hypertension in 22 tertiary medical college hospitals in Bangladesh. The study recruited male and female hypertensive patients of age ≥18 years between July 2020 to February 2021 using consecutive sampling

methods. Health related quality of life was measured using the widely-used index of EQ-5D that considers 243 differ- ent health-related attributes and uses a scale in which 0 indicates a health state equivalent to death and 1 indicates

perfect health status. The five dimensions of the quality index included mobility, self-care, usual activities, pain or discomfort, and anxiety or depression. Ordered logit regression and linear regression models were used to estimate the predictors of comorbidity and HRQoL. Results: Of the 1,912 hypertensive patients, 56.2% were female, 86.5% were married, 70.7% were either overweight or obese, 67.6% had a family history of hypertension, and 85.5% were on anti-hypertensive medication. Among the individuals with comorbidities, 47.6% had diabetes, 32.3% were obese, 16.2% had heart disease, 15% were visually impaired, and 13.8% were suffering from psychological diseases. HRQoL was found to be inversely proportional to the number of comorbidities. The most frequent comorbidities of diabetes and obesity showed the highest EQ- 5D mean utilities of 0.59 and 0.64, respectively. Conclusions: Prevalent comorbidities, diabetes and obesity were found to be the significant underlying causes of

declining HRQoL. It is recommended that the comorbidities should be adequately addressed for better HRQoL. Spe- cial attention should be given to address mental health issues of patients with hypertension.