Health-Related Quality of Life Among Patients with Hypertension in Primary Care: A Systematic Review of SF-36-Based Studies

Abstract

Introduction. Hypertension is a major modifiable risk factor 
for cardiovascular disease and premature mortality and can 
substantially impair health-related quality of life (HRQoL). The 
36-Item Short Form Health Survey (SF-36) is a widely validated 
instrument for evaluating HRQoL. This review systematically 
assessed HRQoL among adults with hypertension in primary 
care and community settings using the SF-36.
Methods. A systematic review was conducted according to 
PRISMA 2020 guidelines. PubMed/MEDLINE, Scopus, Web of 
Science, Embase, and the Cochrane Library were searched for 
studies published from January 2015 to December 2025. Eligible 
studies included adults with primary hypertension assessed 
using the SF-36 in primary care or community-based settings. 
Study characteristics, participant demographics, SF-36 domain 
scores, and factors associated with HRQoL were extracted and 
narratively synthesized.
Results. Evidence consistently indicated reduced HRQoL 
among individuals with hypertension, particularly in physical 
functioning, vitality, general health, and role-physical domains. 
Poorer HRQoL was associated with comorbid diabetes, obesity, 
cardiovascular disease, depression, older age, and inadequate 
blood pressure control. Lifestyle modification, effective blood 
pressure management, patient education, and multidisciplinary 
primary care interventions were associated with improved HRQoL.
Conclusions. HRQoL is an important patient-centered outcome 
in hypertension management. Routine SF-36 assessment may 
help general practitioners identify unmet needs and develop 
individualized care strategies. Longitudinal studies are needed 
to evaluate interventions that simultaneously improve blood 
pressure control and HRQoL.