OBJECTIVES: To examine associations between 1) hypertension treatment strategy; 2) demographic characteristics; and 3) change in utility scores for SF-6D dimensions with patients’ self-reported change in health status. METHODS: INVEST patients randomized to a calcium antagonist- or atenolol-led high blood pressure treatment strategy residing in the United States were surveyed between April 1 and October 31, 1999 (N = 2317). The survey contained the SF-36 HRQoL items. Baseline and 12 month SF-6D utility indices were calculated for study subjects who completed both surveys (n=1010). Subjects who indicated that their health was better or worse compared to last year were classified as having an important change in their self-reported health status. Baseline and 1-year mean SF-6D indices and utility scores for each SF-6D dimension were compared within each treatment strategy using paired t-tests. Independent t-tests assessed differences between treatment strategy and utility scores for each SF-6D dimension and for change in SF-6D index. Hierarchical logistic regression models were used to identify variables associated with health status change. RESULTS: Mental health, role limitation, and pain utility scores were improved among those assigned to the verapamil-SR-led strategy; only mental health was improved among those assigned to the atenolol-led strategy (p<0.05). Patients reporting worsened health status were more likely to have negative utility score changes on the physical and social functioning, role limitation, pain, and vitality domains.  Patients reporting improved health status had positive utility score changes in the mental health, social functioning, role limitation, pain, and vitality domains. Treatment strategy was not associated with health status change. Non-Caucasians were more likely to report improved health status.  CONCLUSIONS: Verapamil-SR hypertension treatment was associated with utility score improvements in multiple SF-6D domains.  However, drug treatment’s effect was apparently not noticeable enough for it to be associated with patients’ judgments that their health improved or worsened.