Quality of life issues in hypertension: consequences of diagnosis and considerations in management.

Most patients with mild to moderate hypertension are asymptomatic. Any adverse response to nonpharmacologic or pharmacologic therapies can negatively influence some aspect of the patient's sense of well-being and life satisfaction; this will likely limit the compliance with and the resultant benefits of therapy. The diagnosis of hypertension itself is associated with psychological consequences, termed the "labeling effect," that impair life quality. A number of life-style modifications and a variety of highly effective and safe classes of antihypertensive agents can satisfactorily control blood pressure in most patients. Evaluation of the patient's response to an antihypertensive regimen should, in addition to measurement of the level of blood pressure and review of laboratory test values, include assessment of quality of life outcomes: impact of therapy on the patient's daily routine, fatigue or activity limitation, sexual dysfunction, impairment of memory, alertness, mood, or cognitive ability, sleep dysfunction, work performance and satisfaction, and satisfaction with family, social, and leisure time activities.