Hypertension is one of the most prevalent chronic diseases in China, with its incidence showing a trend toward younger age groups. Unhealthy behavioral lifestyles are a significant risk factor for the development of hypertension. Therefore, it is crucial to investigate the impact of lifestyle behaviors on the quality of life in individuals with hypertension.

To investigate the impact of behavioral lifestyle on the quality of life in hypertensive patients and provide a scientific basis for developing effective behavioral intervention strategies.

The data for this study were derived from the 2022 Psychological and Behavioral Investigation of Chinese Residents (PBICR-2022), with hypertensive individuals as the study population (n=1 525). General characteristics and behavioral lifestyle information of the participants were collected. Physical activity levels were assessed using the International Physical Activity Questionnaire Short Form (IPAQ-7), and quality of life was evaluated using the EuroQol Five-dimensional Five-level Questionnaire (EQ-5D-5L). The impact of behavioral lifestyle on quality of life was analyzed using multiple linear regression and restricted cubic spline models.

The median EQ-5D-5L utility value was 0.951 (0.893, 1.000), and the median EQ-VAS score was 75.0 (60.0, 85.0) in hypertensive patients. The results of multiple linear regression analyses indicated that daily breakfast consumption, sleep quality, and daily sitting duration were significant factors influencing the EQ-5D-5L utility values and EQ-VAS scores (P<0.05). Current consumption of sugary beverages and average daily water intake were identified as factors influencing the EQ-VAS scores (P<0.05), while weekly physical activity level was found to be a significant factor for EQ-5D-5L utility values (P<0.05). The restricted cubic spline analysis revealed a linear dose-response relationship between daily sitting duration and both EQ-5D-5L utility values and EQ-VAS scores (P_{overall trend}<0.05, P_non-linear>0.05), with both utility values and EQ-VAS scores declining as daily sitting duration increased when the daily sitting duration exceeding four hours. Additionally, a near "n" -shaped nonlinear dose-response relationship was observed between weekly physical activity level and EQ-5D-5L utility values (P_{overall trend}<0.05, P_non-linear<0.05). As weekly physical activity level increased, the EQ-5D-5L utility values initially increased and then slightly decreased, with the peak occurring at a weekly physical activity level of 3 750 MET-min/week.

Adopting the habit of eating breakfast, increasing daily water intake, developing good sleep habits, and reducing the consumption of sugary beverages can improve the quality of life in hypertensive patients. In contrast, daily sitting duration exceeding four hours, as well as insufficient or excessive physical activity, may negatively impact the quality of life of hypertensive patients.