Health behavior and health-related quality of life in patients with a high risk of cardiovascular disease

Abstract

Original scientific articleBackground: Health-related quality of life (HRQoL) is measuring a patient's experience of his health status and represents an outcome of medical interventions. Existing data proves that a healthy lifestyle is positively associated with HRQoL in all age groups. Patients with a high risk for cardiovascular disease typically led an unhealthy lifestyle combined with risk diseases. We aimed to analyse these characteristics and their reflection in HRQoL. Methods:A cross-sectional study in 36 family practices, stratified by location and size. Each practice invited 30 high-risk patients from the register. Data were obtained from medical records and patient questionnaire. The EQ-5D questionnaire and the VAS scale were used for measuring the patient's HRQoL as an independent variable.Results: 871 patients (80.6% response rate) were included in the analysis. 60.0% had 3-4 uncontrolled risk factors for CVD. The average VAS scale was 63.2 (SD 19.4). The correlation of EQ-5D was found in the number of visits in the practice (r=-0.31, p<0.001), the socioeconomic status (r=-0.25, p=0.001), age (r=-0.27, p=0.001) and healthy diet (r=0.20, p=0.006). In a multivariate model, only physical activity among lifestyle characteristics was an independent predictor of HRQoL (p=0.001, t=3.3), along with the frequency of visits (p<0.001, t=-5.3) and age (p=0.025, t=-2.2). Conclusion:This study has been performed on a specific group of patients, not being "really sick", but having less optimal lifestyle in many cases. Encouragement to improve or keep healthy lifestyle, especially physical activity, is important, not only to lower the risk for CVD, but also to improve HRQoL. Izhodišča Metode: Presečna raziskava je bila izvedena v 36 ambulantah družinske medicine, stratificiranih glede na lokacijo (mesto, podeželje) in velikost (do dva oz. več polno zaposlenih zdravnikov na lokaciji). Vsaka ambulanta je k sodelovanju povabila 30 bolnikov iz registra visoko ogroženih za nastanek bolezni srca in ožilja (BSO) po Framinghamski tabeli ogroženosti. Ustrezni podatki so bili pridobljeni iz zdravstvenih kartotek in s pomočjo vprašalnikov za bolnike. Z zdravjem povezana kakovost življenja je bila merjena s petdimenzionalnim EQ-5D vprašalnikom in z VAS lestvico kakovosti življenja, ki sta predstavljala neodvisni spremenljivki.Rezultati: V analizo je bilo vključenih 871 bolnikov (80,6 % vseh vabljenih). Od teh je 60,0 % imelo 3-4 prisotne dejavnike tveganja za nastanek BSO. Povprečna vrednost VAS lestvice je bila 63,2 (SE 0,72). Ugotovljena je bila korelacija med EQ-5D in pogostostjo obiskov bolnika v enem letu v ambulanti (r=-0,31, p<0,001), socialnoekonomskim statusom bolnika (r=-0,25, p=0,001), starostjo bolnika (r=-0,27, p=0,001) in zdravim načinom prehranjevanja (r=0,20, p=0,006). Med vsemi spremenljivkami so bili v multivariatnem modelu neodvisni napovedni dejavniki HRQoL telesna aktivnost (p=0,001, t=3,3), pogostost obiskov bolnika v ambulanti (p<0,001,3) in starost bolnika (p=0,025, t=-2,2 Petek D, Petek-Ster M, Tusek-...

Percepción de Salud General y Calidad de Vida de Puertorriqueños/as con Enfermedades Cardiovasculares.

“…De igual manera, los datos reflejaron que existe relación significativa entre EC (coronaria y derrame) en personas puertorriqueñas y la CVRS, tanto física como mental. Estos datos reflejan lo fundamentado en la literatura que establece que existe una relación inversa entre EC y CVRS estableciendo a mayor riesgo de padecer de EC se presenta mayor riesgo de reportar una CVRS pobre (Rosario et al, 2014;Petek et al, 2018).…”

“…La calidad de vida relacionada con la salud (CVRS) es definida como el concepto multidimensional para medir la experiencia de los pacientes y los resultados de las intervenciones con su salud (Petek, Petek-Ster, & Tusek-Bunc, 2018). De igual manera, permite auscultar la gravedad de la enfermedad, aporta información independiente y permite realizar evaluaciones de costo-eficacia a la hora de implementar nuevas opciones terapéuticas (Comín-Colet et al, 2016).…”

“…Los estudios realizados sobre el tema mencionan que los pacientes de alto riesgo de padecer enfermedades cardiacas, tienen un mayor riesgo a presentar una CVRS pobre (Petek et al, 2018). Las personas con EC reportan CVRS pobre en comparación con la población general (Djärv, Wikman, & Lagergren, 2012).…”

“…Por otro lado, se ha evidenciado que la depresión y la enfermedad cardiaca son comunes e impactan tanto la calidad de vida como la prognosis del paciente debido a la poca adherencia al tratamiento (Morys, Pachalska, Bellwon, & Gruchala, 2016). También, existe mayor impacto en la CVRS en pacientes mayores, mujeres, de menor nivel educativo, personas que viven solas y aquellos que atienden frecuentemente a sus citas (Petek et al, 2018). De igual forma, el estudio mostró que el mayor riesgo de presentar una pobre CVRS pareció ocurrir en pacientes con angina y fibrilación auricular.…”

Patterns of physical activity and health-related quality of life amongst patients with multimorbidity in a multi-ethnic Asian population

“…Studies in the general population have shown a consistently positive association between selfreported physical activity and HRQoL [34]. Thus, not surprisingly, physical activity also improves HRQoL in patients with chronic medical conditions like cardiovascular disease [35], diabetes [36], and stroke [37]. However, the effect of physical activity on HRQoL amongst patients with multimorbidity is not well studied.…”