Health-related quality of life and associated factors among community-dwelling older adults with cardiovascular diseases in Vietnam: a nationwide cross-sectional study using EQ-5D-5L

Objectives To describe health-related quality of life (HRQoL) and to examine factors associated with HRQoL among community-dwelling older adults with cardiovascular diseases (CVDs) in Vietnam. Methods We conducted a multicenter descriptive cross-sectional study with analytical components in eight provinces/cities (Ha Giang, Thai Binh, Nghe An, Dak Lak, Dong Nai, Can Tho, Hanoi, and Ho Chi Minh City) from October 2021 to September 2025. Participants were adults aged ≥ 60 years who were identified as having at least one cardiovascular disease based on self-reported medical history and verification with medical records (when available). Data were collected through face-to-face interviews using a structured questionnaire and the EQ-5D-5L. EQ-5D-5L index scores were derived using the Vietnamese value set. Descriptive statistics were presented as frequencies/proportions and mean ± SD; group comparisons used appropriate statistical tests. Independent factors associated with HRQoL were identified using a multivariable Generalized Linear Model (GLM), with 95% confidence intervals estimated via bootstrapping. Results A total of 2,330 older adults with CVDs were included in the analysis. The mean EQ-5D-5L index score was 0.7175 ± 0.1468. Across CVD subgroups, mean scores ranged from 0.6552 ± 0.1394 (peripheral/venous vascular disease) to 0.7482 ± 0.1417 (valvular heart disease). In the multivariable GLM, lower HRQoL was independently associated with poor household economic status (β = −0.028; 95% CI: −0.047 to − 0.009; p = 0.004), multimorbidity with ≥ 4 comorbid conditions (β = −0.028; 95% CI: −0.036 to − 0.019; p = 0.001), and increasing disease duration (2–5 years: β = −0.080; 95% CI: −0.082 to − 0.077; p = 0.001; 6–10 years: β = −0.221; 95% CI: −0.228 to − 0.213; p = 0.001; >10 years: β = −0.450; 95% CI: −0.459 to − 0.441; p = 0.001). Lower secondary/high school education was also associated with lower HRQoL compared with university/postgraduate education (β = −0.013; 95% CI: −0.022 to − 0.004; p = 0.001). Conclusions HRQoL among community-dwelling older adults with CVDs in Vietnam is reduced, with prominent burdens in pain/discomfort and anxiety/depression. HRQoL is strongly influenced by multimorbidity, longer disease duration, and socioeconomic disadvantage.