Baseline Correlates with Quality of Life Among Men and Women with Medication‐Controlled Hypertension. The Trial of Nonpharmacologic Interventions in the Elderly (TONE)

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Abstract
OBJECTIVES: To examine Quality of Life (QOL) and its correlates among older adults with medication‐controlled hypertension. DESIGN: Baseline data from the TONE clinical trial. MEASUREMENTS: Demographic variables (age, race, income), hypertension treatment (medication class, years treated), health status (obesity, physical symptoms), and QOL status (MOS‐Short‐Form 36, Jenkins Sleep Disturbance, and CES‐D Depression). PARTICIPANTS: A total of 975 men and women, aged 60 to 81 years and free of major diseases and disability, with a screening blood pressure (BP) of < 145/85 mm Hg, treated medically for hypertension with antihypertensive medication. RESULTS: On average, TONE participants reported a QOL level on the SF‐36 that was similar to or better than that reported by older adults in the general population. However, there was a strikingly high prevalence of physical complaints or symptoms: 90.3% of men and 93.3% of women experienced one or more physical symptoms or complaints, and nearly 50% reported that such symptoms had disrupted their daily functioning. Among variables considered, only the physical symptoms index score, number of severe symptoms, and obesity status were correlated consistently with QOL among TONE men and women. Lower QOL scores were associated with higher symptom scores and with obesity. Neither medication class nor age were appreciably associated with QOL status. CONCLUSIONS: Physical symptoms, rather than medication class and age, were the strongest correlates of QOL in TONE. This underscores the importance of identifying the etiology of symptoms as a means to improve the QOL of older hypertensive persons rather than substituting medication. The association of poorer physical well‐being with obesity suggests that weight reduction to manage BP may also improve QOL for some individuals.