Study on the association of unhealthy lifestyles on health-related quality of life in elderly hypertensive patients in rural areas of China

This study aims to explore the associations between unhealthy lifestyle behaviors and health-related quality of life (HRQoL) among rural elderly patients with hypertension. Data were derived from the NCLM‑Cohort_2023–2024 Database, covering 1105 rural elderly hypertensive patients. General demographic and unhealthy‑lifestyle data were collected. HRQoL was measured using the EuroQol Five‑Dimension Five‑Level Scale (EQ‑5D‑5L). Univariate and Tobit regression analyses were performed to explore associations between unhealthy lifestyles and HRQoL. The median EQ‑5D‑5L utility value was 0.952 (0.894, 1.000), and the median EQ‑Visual Analog Scale (VAS) score was 80.00 (70.00, 84.00). Tobit regression showed multiple demographic and lifestyle factors were significantly associated with HRQoL ( P < 0.05). Ethnic minority status was positively associated with higher EQ‑5D‑5L utility values and EQ‑VAS scores. Coughing or loud snoring, difficulty falling asleep, daily sitting duration, weekly moderate physical activity days, and never/rare consumption of pickles‑preserved vegetables and pickled meat‑fish products were inversely associated with both outcomes. For EQ‑5D‑5L utility value, senior high‑school‑and‑above education, high‑normal blood pressure and sleep duration ≥ 7 h, whereas age and never/rare dessert consumption were negative correlates. For EQ‑VAS score, living alone, spousal cohabitation, and never/rare ultra‑processed‑food consumption were positive correlates; annual household income ≥ 8000 yuan, nocturnal or early‑morning awakenings, and dyspnea were negative correlates. This cross‑sectional study identified common correlates of the EQ‑5D‑5L utility value and EQ‑VAS score among rural elderly hypertensive patients, including ethnicity, difficulty falling asleep, coughing or loud snoring, daily sitting duration, and weekly moderate‑physical‑activity days.