Stress-induced effects on the quality of life among hypertensive adults in the Ashanti Mampong municipality, Ghana

Hypertension remains one of the leading causes of illness and premature death worldwide, yet its emotional and social burden is often underestimated. This study examined the association between stress and domain-specific quality of life (QoL) among hypertensive adults aged 30 years and above in the Ashanti Mampong Municipality, Ghana. A cross-sectional mixed-methods design was employed among 320 hypertensive adults aged 30 years and above. Quantitative data were collected using the PSS-10 and WHOQOL-BREF, while qualitative insights were derived from focus group discussions with patients and interviews with healthcare providers. Chi-square tests examined associations between stress and sociodemographic factors, and logistic regression assessed relationships between stress and QoL domains. Qualitative data were thematically analysed. Chi-square analysis revealed that perceived stress varied significantly by age, sex, education, employment, and income (all p < 0.001), with higher stress observed among older adults, females, those with lower education, unemployed individuals, and lower-income participants. In the multivariable binary logistic regression, higher stress was associated with lower domain-specific QoL: physical (AOR = 0.887, 95% CI: 0.842–0.935, p < 0.001), psychological (AOR = 0.898, 95% CI: 0.862–0.935, p < 0.001), social (AOR = 0.918, 95% CI: 0.882–0.956, p < 0.001), and environmental well-being (AOR = 0.915, 95% CI: 0.879–0.954, p < 0.001). Qualitative findings further contextualized these results, highlighting themes of financial strain, caregiving burden, and fear of hypertension-related complications. Socioeconomic vulnerability intensifies stress and diminishes the QoL among people living with hypertension. Integrating stress screening, psychosocial counselling, and financial support within hypertension management policies is essential for improving patient outcomes.