IJCS | Volume 33, Nº2, March / April 2020

138 Table 3 - Factors associated with quality of life in the emotional domain in hypertensive individuals Variables Vitality Social aspects Emotional aspects Mental Health Crude Adjusted Crude Adjusted¹ Crude Adjusted Crude Adjusted b p b p b p b P b p b p b p b P Demographic Sex (% women) 0.121 0.300 ns ns 0.093 0.426 0.034 0.773 -0.073 0.535 Age (years) 0.017 0.885 -0.013 0.916 0.120 0.308 0.174 0.141 ns ns Educational level (years) 0.150 0.227 ns ns 0.344 0.004 0.332 0.006 0.036 0.770 -0.027 0.829 Clinical parameter and physical fitness Hypertension time (years) -0.079 0.507 0.153 0.196 ns ns -0.076 0.253 ns ns 0.023 0.848 Medications (units) -0.107 0.371 -0.121 0.306 -0.179 0.130 ns ns -0.115 0.335 SBP (mmHg) 0.030 0.807 -0.030 0.805 0.136 0.259 ns ns 0.061 0.617 DBP (mmHg) -0.041 0.735 -0.042 0.730 -0.082 0.497 -0.035 0.771 Muscle strength (kgf) 0.073 0.537 0.053 0.649 ns ns 0.017 0.886 -0.162 0.167 ns ns Body mass index (kg/m²) 0.067 0.565 0.131 0.253 -0.067 0.559 -0.208 0.069 ns ns B: pattern regression coefficient. SBP: systolic blood pressure; DBP: diastolic blood pressure, ns: non significant. ¹r = 0.344; r² = 0.118, F = 8.832, p = 0.004. quality of life, which is a reflection of greater impairments in the physical aspects of these individuals, due to the disease. 51,52 A possible explanation for the association found in the present study is the fact that patients with higher blood pressure may be aware of their status and look for alternatives besides medication or exercise in order to improve their blood pressure levels, such as nutritional interventions, smoking cessation, improvements in sleep quality and stress control. This behavior could have affected the relationships due to the fact that they are strategies recommended in literature, 53 which could improve their physical aspect without improving blood pressure levels initially. Interestingly, when hypertensive individuals were submitted to exercise training programs, aspects related to the quality of life improved in 6 to 10 weeks after the beginning of the program, 54 whilemodifications in biological variables, such as blood pressure, occurred later (over 12 weeks from the intervention). 55 Women showed worse quality of life in the pain domain compared to men. These results are similar to a previous epidemiological study with 4,506 adults that observed that muscle pain, headache and pain perception in the SF-36 were worse in women than in men. 56 To explain this relationship, the literature indicates that the pain perception is influenced by complex interactions between biological variables (sexual hormones, genetics, pain pathways and variations in the central nervous system) and psychosocial variables (depression, anxiety, depreciation on the job market, gender role expectations, social learning factors and importance given to pain), where women are more susceptible to the symptoms, especially in advanced age due to menopause and hormonal dysfunctions. 56,57 Silva et al. Factors associated with quality of life Int J Cardiovasc Sci. 2020; 33(2):133-142 Original Article