Comparative Study on Quality of Life of Hypertensive Patients with and Without Diuretics

Abstract

Introduction: Hypertension is a chronic health condition that significantly impairs quality of life (QoL) and increases the risk of cardiovascular morbidity. Diuretics, a primary antihypertensive class, are extensively used for managing fluid overload and hypertension. However, the influence of diuretics on patient-reported QoL outcomes compared to other antihypertensives remains insufficiently explored.

Objectives:This study aims to compare the quality of life of hypertensive patients with and without diuretics.

Methods: A prospective observational study was conducted in a 450 bedded tertiary care hospital. The study included hypertensive patients categorized into two groups: those receiving diuretics and those not. HRQoL was assessed using the EQ-5D-5L instrument and EQVAS. Symptom burden was evaluated using HSS, and sleep quality was assessed via the PSQI. Data were analyzed and compared using an appropriate statistical tool.

Results: The majority of patients were aged 65–75 years. The diuretic group showed a significantly higher incidence of pain/discomfort (p=0.037) and poorer sleep outcomes, including significantly higher global PSQI scores (p=0.005), worse subjective sleep quality (p=0.026), and shorter sleep duration (p=0.009). Mean EQ-VAS scores were slightly lower in the diuretic group (75.07 ±7.20) than the non-diuretic group (77.15 ±8.77). While the HSS indicated a slightly better symptom profile for diuretic users (6.47 ± 2.78 vs. 6.76 ± 2.72), this difference was not statistically significant. A significant moderate positive correlation was found between HSS and PSQI scores across both groups (p<0.001).

Conclusions: Although the use of diuretics results in only slight alleviation of symptoms associated with hypertension, it causes a substantial disturbance in sleep patterns and an increase in physical discomfort. The results show that disturbances in sleep (presumably due to nocturia) are the main contributing factors to the slight reduction in HRQoL in the diuretic group. Although these side effects can be tolerated, diuretics can still be considered a useful treatment choice due to their relative tolerability.