Quality of life during antihypertensive treatment. Refining its measurement to individualize drug selection.

Three questions relating to assessment of quality of life during antihypertensive therapy are discussed here. 1. Can the quality of life be measured? The two approaches thus far explored have used external parameters, such as counting days of work lost or changes in sexual function, and subjective assessment by patients, through completion of a questionnaire. The latter presents problems of reliability and sensitivity of the instrument as well as comparability of results across various studies. 2. Should quality of life be measured? If morbidity due to hypertension is reduced but quality of life is also reduced without an associated improvement in longevity, it is important to know exactly how and to what extent quality of life is impaired. Also, measurement of quality of life should make possible improved compliance with antihypertensive therapy. 3. How can quality of life be measured? Results of the studies evaluating quality of life associated with antihypertensive therapy leave much to be desired. A study protocol is proposed that would use the voluntary drop-out rate as the point of comparison. Research would then unravel the behavioral factors specifically affected by a given treatment. Through such studies, the effects of drugs on quality of life could become a criterion in individualization of treatment.