How should changes in life-style be measured in cardiovascular disease?

Traditionally, assessment of therapy has been judged by the ability of treatment to alleviate symptoms with tolerable side effects or toxicity. In recent years, it has become obvious that more subtle and patient-oriented approaches are urgently needed to evaluate progression of cardiovascular disease and to monitor the efficacy of medical and surgical therapy. Aspects of well-being include physical, emotional, and social status in cardiovascular diseases. While several major assessment methods are available within the social sciences, experiences with the use of comprehensive questionnaires in cardiovascular diseases remains relatively limited. Self-administered questionnaires have been shown to be more reliable than those given by a trained interviewer. Two forms of questionnaires--the visual analogue scale and the one in which patients check off boxes--can be used to quantify symptoms, but the former necessitates more time spent on patient information. Measurements of quality of life can be characterized by the test's validity, reproducibility, and sensitivity. Our information on the sensitivity of life-quality tests is so far scarce, but it has recently been shown that it is possible to discern the effect of various drug treatments in hypertension. The methodology of this assessment needs to be further optimized, and the quality of life parameters need to be correlated with hemodynamics, exercise capacity, morbidity, and mortality.