Quality of life and treatment adherence in hypertensive patients: systematic review with meta-analysis

ABSTRACT OBJECTIVE To verify the effects of antihypertensive treatment (pharmacological and non-pharmacological) on the health-related quality of life of individuals with hypertension. METHODS We conducted a systematic review with meta-analysis using the following databases: IBECS, LILACS, SciELO, Medline, Cochrane, Science Direct, Scopus and the Brazilian Capes Theses and Dissertations Database. The statistical analysis was performed using Review Manager, version 5.2. The average difference was used for the summarization of meta-analytic effect by the fixed-effect model. Twenty studies were included. RESULTS The summarization of the effect showed an average increase of 2.45 points (95%CI 1.02–3.87; p < 0.0008) in the quality of life of individuals adhering to non-pharmacological treatment for arterial hypertension. Adherence to pharmacological treatment indicated an average increase of 9.24 points (95%CI 8.16–10.33; p < 0.00001) in the quality of life of individuals with arterial hypertension. CONCLUSIONS Non-pharmacological treatment improves the overall quality of life and physical domain of people with arterial hypertension. Adherence to pharmacological treatment has a positive impact on the mental and physical domains of patients, as it did on the overall quality of life score.

摘要
【目的】验证降压治疗（含药物性与非药物性干预）对高血压患者健康相关生存质量的影响。
【方法】本研究采用系统评价联合元分析（meta-analysis）方法，检索数据库包括IBECS、LILACS、SciELO、Medline、科克伦数据库（Cochrane）、Science Direct、Scopus以及巴西卡佩斯学位论文数据库（Brazilian Capes Theses and Dissertations Database）。统计学分析采用5.2版Review Manager软件完成，以固定效应模型计算元分析效应量的合并均数差。最终纳入20项研究。
【结果】效应汇总分析显示，依从动脉高血压非药物治疗方案的患者，其健康相关生存质量平均提升2.45分（95%CI 1.02~3.87；p<0.0008）；依从药物治疗的动脉高血压患者，健康相关生存质量平均提升9.24分（95%CI 8.16~10.33；p<0.00001）。
【结论】非药物治疗可改善动脉高血压患者的整体生存质量及躯体功能维度；依从药物治疗则对患者的精神与躯体功能维度均具有积极影响，同时可提升整体生存质量评分。