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Hypertension is a disease that causes systematic complications such as coronary artery disease, stroke, and kidney failure and threats human life and health. About 32% of the American adults suffer from hypertension, and about half of them are receiving treatment for hypertension (Merai et al., 2016). Hypertension is influenced by age, family history, obesity, inaction, smoking, intake of salt, and stress (Merai et al., 2016). In particular, age is a major risk factor and there is a close relationship between aging and the occurrence of systolic hypertension (McEniery, Wilkinson, & Avolio, 2007). Similarly, in Korea, hypertension incidence has been reported to increase with age (Korean Statistical Information Service, 2016).
In middle-aged adults, the risk of hypertension is very high (Vasan et al., 2002). As the blood vessel becomes harder, it affects the blood pressure, and the diastolic blood pressure reaches the peak in middle age (The Korean Academy of Clinical Geriatrics, 2011). As vascular disease, major cause of death in middle age is closely related to hypertension, adults with hypertension in middle age need to pay special attention to managing hypertension.
Reducing blood pressure reduces early mortality as well as cardiovascular disease (National Heart Foundation of Australia, 2016). Therapeutic strategies for hypertension include antihypertensive therapy (drug therapy) and lifestyle advice such as dietary modification, physical activity, weight control, salt restriction, smoking cessation, relaxation therapies (National Heart Foundation of Australia, 2016). Hypertension requires lifelong attention to lifestyle habits and medication intake, so it is difficult to manage consistently. Recently, ubiquitous health (u-Health) has been introduced by the development of information technology (IT) technology, and enabled remote medical service. This is useful for improving access to health care services and helping to fulfill self-care for patients with hypertension (Chung, Moon, & Lee, 2013).
HRQOL is a concept that evaluates the impact of disease on individual’s physical, social, and psychological function comprehensively and thus important for setting therapeutic methods for patients with chronic disease (Tander et al., 2008). As the number of people with chronic diseases increases, the need for evaluation of HRQOL becomes more important. Hypertension, a chronic disease, has been reported to cause a decrease in quality of life related to health because it requires lifelong medication and steady self-management (Yoo & Lee, 2007). In addition, cormobidity, adverse effects of antihypertensive agents, and perception of diagnosis negatively affect HRQOL (Casellas et al., 2008). Middle-aged adults with hypertension have the burden of managing hypertension consistently and undergo physical and psychological changes due to aging phenomenon. This threats daily living functions and diseases or wellbeing resulting from therapeutic intervention (Yoo & Lee, 2007). Therefore, nursing intervention for middle-aged adults with hypertension should focus on improving comprehensive HRQOL that includes not only physical symptoms but also psychological and social ones.
In previous studies, factors affecting HRQOL in patients with chronic illness were reported to depression (Casellas et al., 2008), activity status (Bize, Johnson, & Plotnikoff, 2007), exercise and physical activity (Penedo & Dahn, 2005), age and gender (Johansson, Dahlström, & Broström, 2006), employment status and adverse drug reactions (Muehrer & Becker, 2005), income (Lubetkin, Jia, Franks, & Gold, 2005), aerobic exercise (Shin et al., 2008), stress (Eom, 2009), body mass index (Dan et al., 2006). Therefore, it is necessary to improve their quality of life by analyzing factors influencing on HRQOL of middle-aged adults with hypertension who are faced with physical and psychological crisis. However, previous studies (Eom, 2009; Lee & Cho, 2016) on the health-related quality of life of hypertensive adults were rare in Korea.