The Impact of Antihypertensive Agents on Health-Related Quality of Life of Hypertensive Patients

  • Wajeeha Siddique University of Balochistan, Quetta, Pakistan
  • Noman Haq University of Balochistan, Quetta, Pakistan
  • Maria Tahir Sardar Bahadur Khan Women’s University Balochistan, Quetta, Pakistan
  • Ghulam Razzaque Razaque University of Balochistan, Quetta, Pakistan
Keywords: Hypertension, Health Related Quality of Life, Quetta, ACE Inhibitors, Diuretics, EQ5D-3L


Chronic diseases and their treatment regimen plays a greater role in determining the patient related health outcomes of which one is Health Related Quality of Life. Hypertension itself along with its pharmacotherapy impacts HRQoL of hypertensive patients. The primary objective of the study was to determine the impact of f hypertensive medications on the health-related quality of life among hypertensive patients with the secondary objective to assess which medication significantly affects health related quality of life of hypertensive patients. A quantitative questionnaire based cross-sectional survey was undertaken in outpatient departments of Sandeman Provisional Hospital (SPH) Quetta using an EQ-5D-3L to determine the Health-Related Quality of Life. Convenience Sampling technique was used for data collection. Majority of respondents (8.7%) had no problem in first three domains while having some problem in pain and anxiety domains. Following them 7.6% of patients had some problems in all domains of the EQ5D tool. Moreover. the ACE Inhibitors and Diuretics impacts HRQoL of patients of current study. A total of 263 participated in the study of which (25%) of the respondents were of age group 48 -75 years old and were married 73.4% mostly. Majority (8.7%) had no problem in first three domains while having some problem in pain and anxiety domains. ACE Inhibitors and Diuretics significantly influence the health status of hypertensive patients acquiring pharmacotherapy. It was concluded that antihypertensive agents have a significant impact on HRQoL of hypertensive patients especially Angiotensin Converting Enzymes and Diuretics, which show significant impact on HRQoL of hypertensive patients. However, it is also suggested to assess the impact of antihypertensive therapies given in combination must also be studied in order to provide health professionals a better understanding of their prescribed regimen to improve patient related health outcomes.


[1] Adebusoye, L. A., Ladipo, M. M., Owoaje, E. T., & Ogunbode, A. M. (2011). Morbidity pattern amongst elderly patients presenting at a primary care clinic in Nigeria. African Journal of Primary Health Care & Family Medicine, 3(1), 211. Retrieved from
[2] Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of hypertension. Nature Reviews Nephrology, 16(4), 223-237. Retrieved from
[3] Ogedengbe, A. (2017). Predictors Of Health Related Quality of Life Among Hypertensive Patients Attending General Outpatient Clinic In Federal Medical Centre Owo, Ondo State. Faculty of Family Medicine.
[4] Ghimire, S., Pradhananga, P., Baral, B. K., & Shrestha, N. (2017). Factors associated with health-related quality of life among hypertensive patients in Kathmandu, Nepal. Frontiers in cardiovascular medicine, 4: p. 69. Retrieved from
[5] Wang, T. J., & Vasan, R. S. (2005). Epidemiology of uncontrolled hypertension in the United States. Circulation, 112(11), 1651-1662. Retrieved from
[6] Williams, G. H. (1998). Assessing patient wellness: new perspectives on quality of life and compliance. American Journal of Hypertension, 11(S8), 186S-191S. Retrieved from
[7] Saleem, F., Hassali, M. A., & Shafie, A. A. (2014). A cross‐sectional assessment of health‐related quality of life (HRQoL) among hypertensive patients in Pakistan. Health Expectations, 17(3), 388-395. Retrieved from
[8] Nasim, A., Haq, N. U., Riaz, S., Tahir, M., Saood, M., Yasmin, R., et al. (2018). Health related quality of life (Hrqol)-What it is and how it is measured: Studies from the world and comparison with Pakistan. Indo American Journal of Pharmaceutical Sciences, 5(2), 1086-1095. Retrieved from
[9] Tahir, M., Haq, N. U., Nasim, A., Riaz, S., & Razzaque, G. (2017). Assessment of health related quality of life, HRQoL of diabetic patients using Euro-QoL-5D instrument in Quetta, Pakistan. Indo American Journal of Pharmaceutical Sciences, 4(9), 2939-2948. Retrieved from
[10] Saleem, F., Hassali, M. A., Shafie, A. A., Atif, M., Haq, N. U., & Aljadhey, H. (2012). Disease related knowledge and quality of life: A descriptive study focusing on hypertensive population in Pakistan. Southern med review, 5(1), 47. Retrieved from
[11] Chung, S. C. (2010). Health Related Quality of Life in Clinical Studies for Chronic Diseases—Design and Analytical Considerations, University of Pittsburgh. Retrieved from[ChungSC]Dissertation.pdf
[12] Kring, D. L., & Crane, P. B. (2009). Factors affecting quality of life in persons on hemodialysis. Nephrology Nursing Journal, 36(1), 15-24. Retrieved from
[13] Testa, M. A., Anderson, R. B., Nackley, J. F., Hollenberg, N. K., et al. (1993). Quality of Life and Antihypertensive Therapy in Men--A Comparison of Captopril with Enalapril. New England Journal of Medicine, 328(13), 907-913. Retrieved from
[14] Yan, R., Gu, H.Q., Wang, W., Ma, L., & Li, W. (2019). Health-related quality of life in blood pressure control and blood lipid-lowering therapies: results from the CHIEF randomized controlled trial. Hypertension Research, 42(10), 1561-1571. Retrieved from
[15] Van Hoof, R., Amery, A., Fagard, R., & Staessen, J. (1990). Quality of life during treatment of hypertensive patients with diuretics. Acta Cardiologica, 45(5), 393-401. Retrieved from
[16] Grimm, R. H., Grandits, G. A., Cutler, J. A., et al. (1997). Relationships of quality-of-life measures to long-term lifestyle and drug treatment in the Treatment of Mild Hypertension Study. Archives of Internal Medicine, 157(6), 638-648. Retrieved from
[17] Erickson, S., Williams, B., & L. Gruppen. (2001). Perceived symptoms and health-related quality of life reported by uncomplicated hypertensive patients compared to normal controls. Journal of Human Hypertension, 15(8), 539-548. Retrieved from
[18] Trevisol, D., Moreira, L. B., Fuchs, F. D., & Fuchs, S. C. (2012). Health-related quality of life is worse in individuals with hypertension under drug treatment: results of population-based study. Journal of Human Hypertension, 26(6), 374-380. Retrieved from
[19] Mena-Martin, F. J., Martin-Escudero, J. C., Simal-Blanco, F., Carretero-Ares, J. L., Arzua-Mouronte, D., & Herreros-Fernandez, V. (2003). Health-related quality of life of subjects with known and unknown hypertension: results from the population-based Hortega study. Journal of hypertension, 21(7), 1283-1289. Retrieved from life_of_subjects_with.15.aspx
[20] Neaton, J. D., Grimm, R. H., Prineas, R. J., Stamler, J., Grandits, G. A., Elmer, P. J., et al. (1993). Treatment of mild hypertension study: final results. JAMA, 270(6), 713-724. Retrieved from
[21] Kirushanthan, S. (2019). Health-related quality of life among patients treated with ACE inhibitors and other drugs involved in hypertension treatment. Retrieved from
[22] Croog, S. H., Levine, S., Testa, M. A., Brown, B., Bulpitt, C. J., Jenkins, C. D., et al. (1986). The effects of antihypertensive therapy on the quality of life. New England Journal of Medicine, 314(26), 1657-1664. Retrieved from
[23] Vanmolkot, F., De Hoon, J., Ven de Ven, L., & Van Bortel, L. (1999). Impact of antihypertensive treatment on quality of life: comparison between bisoprolol and bendrofluazide. Journal of Human Hypertension, 13(8), 559-563. Retrieved from
[24] Tedesco, M. A., Ratti, G., Mennella, S., Manzo, G., Grieco, M., Rainone, A. C., et al. (1999). Comparison of losartan and hydrochlorothiazide on cognitive function and quality of life in hypertensive patients. American Journal of Hypertension, 12(11), 1130-1134. Retrieved from
[25] Fletcher, A. (1999). Quality of life in the management of hypertension. Clinical and Experimental Hypertension, 21(5-6), 961-972.
[26] Starr, J. M., & Whalley, L. J. (1994). ACE inhibitors: central actions. Raven Press (ID).
[27] Fogari, R., & Zoppi, A. (2004). Effect of antihypertensive agents on quality of life in the elderly. Drugs & aging, 21(6), 377-393.
[28] Teng, M., Lin, L., Zhao, Y. J., Khoo, A. L., Davis, B. R., Yong, Q. W., et al. (2015). Statins for primary prevention of cardiovascular disease in elderly patients: systematic review and meta-analysis. Drugs & Aging, 32(8), 649-661. Retrieved from
[29] Delles, C., Dymott, J. A., Neisius, U., Rocchiccioli, J. P., Bryce, G. J., Moreno, M. U., et al. (2010). Reduced LDL-cholesterol levels in patients with coronary artery disease are paralelled by improved endothelial function: An observational study in patients from 2003 and 2007. Atherosclerosis, 211(1), 271-277. Retrieved from
[30] Horton, R. (2016). Offline: Lessons from the controversy over statins. The Lancet, 388(10049), 1040.
[31] Strandberg, T.E., Urtamo, A., Kähärä, J., Strandberg, A.Y., Pitkälä, K.H., Kautiainen, H., et al. (2018). Statin treatment is associated with a neutral effect on health-related quality of life among community-dwelling octogenarian men: The Helsinki Businessmen Study. The Journals of Gerontology: Series A, 73(10), 1418-1423. Retrieved from