[Quality of life in patients with risk factors of coronary heart disease]

Abstract

Aim: The objective of the study was to assess the subjective health state and selected parameters of health-related quality of life (QL) in subjects with risk factors of coronary heart disease (CHD). Demographic and clinical variables were analyzed in order to determine factors influencing an individual's satisfaction.

Material and methods: The study enrolled a total of 541 persons (278 women and 263 men; mean age 52 +/- 16.5 years). All the participants were divided into four groups i.e. healthy subjects, persons with one risk factor (hypertension), persons with three risk factors (hypertension, smoking, hypercholesterolemia) and patients with CHD. Quality of life assessment was carried out by means of the international, standardized general questionnaire analyzing mobility, self-care, usual activities, pain, anxiety/depression (five questions, each with three levels) and subjective health state (visual analogue score, VAS).

Results: Persons without any of the analyzed risk factors scored significantly higher within all studied dimensions of QL and VAS. The lowest level of satisfaction was noticed in patient with CHD, especially after myocardial infarction. Patients with untreated hypertension, smoking, hypercholesterolemia, obesity and sedentary lifestyle reported significantly higher degree of disability than persons with well controlled hypertension, free of smoking habit, with no lipid disorders, slim and with at least moderate physical activity level. Among all analyzed risk factors the strongest correlation was found for untreated hypertension and sedentary lifestyle. In healthy subjects demographic variables, as age, sex, marital status, education and employment were the most important determinants of quality of life. The rates of reported problems increased significantly with age, women tended to score lower than men. Pain or discomfort was the most frequent disorder in healthy persons while anxiety or depression and pain in patients with risk factors and coronary heart disease.

Conclusion: Patients with risk factors of coronary heart disease, as hypertension, smoking, hypercholesterolemia, obesity and sedentary lifestyle clearly reported high degree of disability and poor subjective health state. Prevention and treatment should focus especially on effective control of hypertension and promoting physical activity as the strongest determinants of quality of life.