OBJECTIVES: To evaluate the quality of life (QL) in essential hypertensives (EH) of Belarus, a European country with a unique combination of the important rise in cardiovascular morbidity and mortality, highly restricted financing of the state health care system, and the society experiencing socioeconomic hardships. METHODS: In 222 verified mild to moderate EH (mean age 49.4+0.9 years) as well as in 77 age-, gender-, body mass- and social status-matched healthies (H) the QL assessment was performed using the well-validated, self-administered questionnaires: The Giessen Somatic Complaints Questionnaire (GSC) and The General Well-Being Adjustment Scale (GWB). RESULTS: The QL tests revealed significantly lower QL scores on all GSC and GWB subscales in the investigated Belarusian EH compared with H (Gastric Complaints, Pains, Cardiac Complaints, Exhaustion, Anxiety, Depression, Well-Being, Self-Control, General Health, Vitality) with the total Complaints Index (mean+SEM) 52.4+2.6 vs. 22.5+1.9 points (p<0.001), and the total GWB index 78.6+1.3 vs. 94.5+2.1 points (p<0.01), respectively. QL scores did not correlate (Spearman) with office blood pressure and age. Females demonstrated less favorable scores on all subscales compared with males in both groups (Mann-Whitney, p<0.01). Educational level, occupation, physical activity had no impact on the QL (ANOVA). There was an association of the total QL with alcohol and coffee consumption as well as smoking (standardized interview), while abstinents had the lowest QL scores (p<0.05). The QL total indexes were significantly (p<0.05) worse in the EH treated on regular basis compared with EH who did not treat their known hypertension. The high QL score, smoking, drinking and male gender were revealed as factors of poor compliance with previous routine medical care. CONCLUSIONS: Gender and certain life-style factors influence the QL profile of EH living in Belarus and relate to compliance, this requiring careful consideration during hypertension management.