traditional aims in the treatment of congestive heart failure are to relieve symptoms and to improve the
prognosis. Another major goal of health care is to maximise function in everyday life and to achieve the highest level of
quality of life within the specific limits imposed by the disease. Quality of life is a relatively new scientific measure to evaluate effectiveness of treatment strategies and the course of a disease.1–3 In congestive heart failure, several disease specific instruments—such as the Minnesota living with heart failure questionnaire4 — have proved useful in clinical studies.5–11 Disadvantages of these specific measures are that they are difficult to compare across diseases and with controls in the general population. Because they are designed to measure specific aspects of a certain disease, unforeseen side effects of treatment might go undetected (for a detailed review see Guyatt12). Recently, quality of life was shown to be decreased in patients with congestive heart failure in comparison with the general population,13 14 using the medical outcome study 36 item short form health survey (SF-36), a validated, reliable, and multidimensional generic measure of quality of life.15 16 However, the few studies which have investigated the relation between quality of life and clinical variables (reflecting the severity of disease) achieved inconclusive results.17–19 Our major aims in the present study were therefore as follows: to assess the extent of the impairment of quality of life in patients with congestive heart failure in comparison with the general population; to compare specific aspects of alterations in quality of life in congestive heart failure with those in other chronic diseases; and to examine the extent to which health related quality of life is explained by various clinical indices, namely New York Heart Association (NYHA) functional class, peak oxygen uptake, the distance covered during a six minute walk test, and the left ventricular ejection fraction.