Quality of Life and Antihypertensive Drug Therapy

Joel Handler, MD

In This Article

Labeling and Its Effect on QOL

Hypertension labeling also has an effect on patient performance. This is an important issue in view of the new label of "prehypertension" with BPs of 120-139/80-89 mm Hg. Does labeling do any harm? A study of Canadian steelworkers who were unaware of their BP levels but had elevated pressures for more than one year were told that they had hypertension.[11] The newly diagnosed hypertensive patients were referred back to their primary physicians who had apparently not paid much attention to the elevated levels. Eighty-five patients were started on antihypertensive therapy, but 53 did not receive any treatment. All of the patients were told to return in 6 months. Following the diagnosis of hypertension, whether or not they were treated, there was a tripling of days off due to self-reported illness (i.e., absenteeism due to self-reported illness) ( Table 3 ). When patients are labeled as sick they may act sick, but on the other hand, there is another problem with hypertension. Many times it is difficult to convince newly diagnosed hypertensive patients that they are sick enough to require therapy. That is one of the reasons they refuse to begin or continue on medication. In any case, there is a delicate balance we must be careful about when diagnosing hypertension.