Health-related quality of life and its predictors among hypertensive adults 45 years and older in rural Malawi: a population-based study

Susan Banda^1,2, Iliana V. Kohler³, Hans-Peter Kohler⁴, Susan C. Chichlowska¹

1. School of Public Health and Family Medicine, Kamuzu University of Health Sciences
2. Ministry of Health, Ntcheu District Health Office
3. Population Studies Center (PSC) and Department of Sociology, University of Pennsylvania
4. Population Ageing Research Center (PARC) and Department of Sociology, University of Pennsylvania

*Corresponding Author: Susan Banda; E-mail:subanda94@gmail.com

Abstract
Background
Hypertension is associated with impaired Health-Related Quality of Life (HRQOL), but its assessment is rarely done in the management of hypertension in Malawi. This study aimed to evaluate the HRQOL of hypertensive adults compared to normotensive individuals and suggest possible predictors of HRQOL in hypertensive adults in rural Malawi.
Methods
This was a cross-sectional study utilizing data from the 2017 Mature Adults Cohort of the Malawi Longitudinal Study for Families and Health (MLSFH-MAC). The study included 1489 adults aged 45 and above from Rumphi, Mchinji, and Balaka districts. HRQOL was measured using the Short Form 12-item (SF-12) questionnaire. Univariable logistic regression, followed by multivariable logistic regression, was used to identify independent predictors of HRQOL in hypertensive adults. A p-value of <0.05 was considered statistically significant.
Results
The prevalence of hypertension was 44.1%. Hypertensive participants had significantly lower physical and mental HRQOL than their normotensive counterparts (p<0.05). Multiple regression analysis showed that female sex, age, presence of comorbidities, and use of antihypertensive medications were significant predictors of poor physical HRQOL. Being female was a significant predictor of poor mental HRQOL (all p-values <0.05).
Conclusion
In rural Malawi, hypertensive adults presented with lower physical and mental HRQOL. Interventions aimed at improving HRQOL should focus on hypertensive adults who are female, older, on antihypertensive medications, and with comorbidities.