IJCS | Volume 33, Nº2, March / April 2020

134 normotensives, mainly in the parameters related to the physical domain. However, the quality-of-life concept is extended, once it refers to personal satisfaction, defined in relation to the daily life, which is influenced by individual evaluation of physical, psychological, social and spiritual well-being. 6,7 The World Health Organization defines quality of life as “an individual’s perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns.” In this context, different parameters can directly affect the quality of life of these patients. Among these parameters, the physical aspect, for example, evaluated through the physical limitations in daily activities, dissatisfaction with functional capacity and mobility, can negatively reflect the quality of life. 8 Additionally, the frequency with which an hypertensive patient feels body pain or discomforts can interfere with the execution of daily living activities. 9 Thus, these limitations, caused by health, physical or emotional problems related to hypertension, must be better understood for a greater understanding of the quality of life of these individuals. 10 Beyond the physical aspects, deterioration of an individual’smental health, as a reflection of hypertension, can lead to reduced frequency of participation in relevant social activities for the individual’s personal life, for example. 11 In fact, the emotional aspects can be related to damages to one of the four main dimensions of mental health (anxiety, depression, loss of behavioral or emotional control and physiological well-being). 12 Another aspect that deserves attention is related to vitality as energy level and fatigue, which can support the evaluation of the subjectivewell-being of hypertensive individuals. 13 Lastly, evaluating the individual’s general health perception can be interesting, considering the impact of the presence of diseases and its complications in the individual’s health. 10 Therefore, questionnaires that aim to analyze quality of life are necessary, such as the 36-item Short Form Health Survey (SF-36), 14 which consists of 36 items, one of which measures the health transition, and the other 35 are grouped into scales and divided into eight domains: functional capacity, physical aspects, pain, general health, vitality, social aspects, emotional aspects and mental health. These eight domains can also be aggregated in summary: measurements of physical and emotional factors. 15 In this context, some studies have investigated the factors associated with quality of life in hypertensive individuals, given its relevance to the health of those patients. Indeed, the influence of the factors associated with quality of life can predict long-term functional independence, adherence to anti-hypertensive therapy and incidence of survival in hypertensives. 16-18 Previous studies have suggested that clinical aspects directly affect the quality of life in hypertensive individuals, 19 such as comorbidities (heart failure, acute myocardial infarction and angina pectoris), 20 medication, 21,22 disease knowledge level and blood pressure values. 22 On the other hand, it is unknown whether physical fitness and demographic characteristics are related to quality of life in hypertensive individuals. Studies with other population subgroups have demonstrated that increases in muscle strength and body weight reduction, for example, have been constantly related to an improvement in daily activities in healthy elderly individuals, 23,24 leading to greater functional independence and physical fitness, which lead to better quality of life. Indeed, it is known that older individuals, consequently with worse physical fitness, present reduced quality-of- life indicators—due to decreasedmass—of strength and muscle resistance, leading to increased fatigue during the performance of daily activities. 25 Therefore, identifying factors related to quality of life, such as physical fitness, may help health professionals to propose interventions. Thus, the aim of the present study was to analyze the factors associated with quality of life in hypertensive individuals. Our hypothesis is that physical fitness is the main component associated with quality of life in hypertensive individuals. Methods This is a correlational cross-sectional study that analyzed the initial data of an interventional study that analyzed the effects of isometric handgrip training in the blood pressure of hypertensive individuals. 26 All individuals were recruited by flyers in Universidade de Pernambuco in the Santo Amaro Campus, public hospitals, or through media advertisements (online journals and social media) in the city of Recife and metropolitan region. The project was approved by the Research Ethics committee of Universidade de Pernambuco and all patients signed an informed consent form. Subjects The inclusion criteria of the study were: a) use of anti-hypertensive medication; b) age above 18 years; Silva et al. Factors associated with quality of life Int J Cardiovasc Sci. 2020; 33(2):133-142 Original Article