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[Validation of the quality of life questionnaire in arterial hypertension (HQALY) for its use in Spain. Relationship between clinical variables and quality of life. Investigator Group of the HQALY study].

OBJECTIVE
To evaluate the measurement properties of the Hypertension Quality of Life (HQALY) questionnaire, under normal clinical practice conditions, and the relationship between quality of life and clinical variables in patients with hypertension.


DESIGN
Observational, prospective and multi-centred study.


SETTING
92 primary care centres in Spain.


PARTICIPANTS
269 patients, of both sexes and over 17, with hypertension, stratified by age (18-44, 45-64 and over 64), sex and organic complaint. 106 individuals over 17 with normal tension were chosen at random.


INTERVENTIONS
Intensification of treatment in hypertense patients.


MEASUREMENTS
Administration of the HQALY and the EuroQol-5D at every attendance (patients, basal and at a month; controls, basal). In addition, at the basal attendance social-demographic and clinical features were recorded, and at the attendance at a month the clinical features and changes in health status.


MAIN RESULTS
Mean time of administration was 28 (23) minutes.


VALIDITY
factor analysis showed two dimensions, state of mind and somatic manifestations, which correlated most closely with the dimensions of anxiety/depression (0.64) and pain/discomfort (0.55) on the EQ-5D, respectively. HQALY scores were higher (worse quality of life) in patients than in controls without hypertension (p < 0.01). Reliability: intraclass correlation coefficient was 0.88 in state of mind and 0.76 in somatic manifestations. Cronbach's alpha was 0.96 and 0.89, respectively. Sensitivity: the "size of the effect" at a month from starting treatment for hypertension was 0.40. Hypertension for over 10 years, more organs affected, gravity and morbid obesity were associated with worse quality of life, especially in the state-of-mind dimension. Cardiac frequency correlated closer with state of mind than somatic manifestations.


CONCLUSIONS
The HQALY is the first specific hypertension questionnaire developed in Spain which has been shown valid, reliable and sensitive to changes. However, the number of items on it must be reduced for routine use in clinical practice.