QUALITY OF LIFE OF HYPERTENSIVE OUTPATIENTS AND INDIVIDUAL HEMODYNAMIC PHENOTYPE: IS THERE A RELATIONSHIP?
Objective. To study the quality of the life (QL) in hypertensive patients on the standard medical out-patient treatment and its relationship with the individual hemodynamic phenotype. Materials and methods. Totally, 175 ambulatory patients with primary arterial hypertension AH (not less than 3 years longevity) on the standard treatment with basic antihypertensive drugs were examined. The QL was assessed using the general RAND-36 questionnaire (Russian version). The hemodynamic phenotype for every patient was defined by individual statistical modeling on blood pressure parameters received by daily measurements at home (at least 25 units for each patient within 2-4 weeks). Results. The most frequent hemodynamic types in the observation group were: harmonious (H) - in 53.6% of patients and diastolic dysfunctional (D) - in 46.3% of subjects. The D-type was identified more often in the older patients and in those demonstrating higher hypertension grades. The QL of the patients with the D type was lower than in case of the H type both in men and in women being especially significant on the physical functioning (PP) scale. Among the type D patients, significantly more persons didn't attain the target BP level when treated- 40.7% (among the type H subjects- only 25.8%). When the target BP was not achieved on the treatment the QL of the patients decreased significantly compared with the patients who had achieved the target BP: in the patients with the D type - on the most QL scales including the general QL level; in patients with H-type - only on the QL physical component. Increase in the quantity of drugs taken (2 and more units) in the D-type patients reliably reduced the QL by most parameter and in the H type patients it was not accompanied by the QL significant lowering, however, the frequency of the target BP achievement did not increase.