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      Differential Control Rate of Systolic and Diastolic Blood Pressure among Korean Adults with Hypertension: the Sixth Korean National Health and Nutrition Examination Survey, 2013–2015 (KNHANES VI)

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          Abstract

          Background and Objectives

          Discrepancy in blood pressure (BP) control rate may be owed to different risk factors associated with elevated systolic and diastolic BP (SBP and DBP).

          Methods

          In a nationally representative survey of Korean population with BP measurements, a total of 5,100 participants with hypertension was included in the analyses. Three separate types of control rates were calculated: SBP, DBP, and (combined) S&DBP among all participants with hypertension and participants with treated hypertension, separately. Control rates were compared across sex and age groups. Multivariable logistic regression was used to identify demographic factors associated with SBP, DBP, and S&DBP control rates, separately.

          Results

          In total, SBP, DBP, and S&DBP control rates were 63.0%, 63.7%, and 42.5% among all hypertension patients, and 77.5%, 87.4%, and 71.6% among treated hypertension patients. Men aged 40–49 years with hypertension and 30–39 years treated for hypertension had the highest SBP control rate (74.6% and 96.2%), which decreased by older age. Inversely, DBP control rate progressively increased with older age. SBP control rate among women with hypertension was the highest in 40–49 years (67.0%) but without linear trend by age group. Interestingly, both combined and DBP control rates were noticeably low among women aged 50–59 years. Women with body mass index ≥25 were at higher odds of having controlled SBP. Lower DBP control rate was observed in men with lower education level, higher household income, and heavy drinkers.

          Conclusions

          Separate examination of control rates demonstrated different sex- and age-differential trends, which would have been overlooked in combined control rates.

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          Most cited references16

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          2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

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            Hypertension and socioeconomic status.

            The impact of socioeconomic status on hypertension is complicated and unclear. In this article, we review the findings of recently published studies pertaining to the association between socioeconomic status and hypertension. Specifically, we focus on several potentially modifiable modes of pathogenesis involved in this association, including education, occupation, and social environment. We also review several mechanisms through which the effects of socioeconomic status on hypertension may be mediated. Several modifiable socioeconomic determinants, such as education and occupation, are associated with hypertension. Additional socioeconomic status markers such as urban or rural dwelling and individual, local or national economic conditions are also associated with hypertension, although these associations are complicated and at times somewhat contradictory. Possible explanations for this impact include awareness of hypertension prevention and control and better accessibility and adherence to medical treatment among higher socioeconomic status groups, as well as low birth weight and higher job strain among lower socioeconomic status groups. Low socioeconomic status is associated with higher blood pressure. There is a need to develop and test culturally appropriate interventions to reduce the prevalence of hypertension among these populations to minimize the resultant cardiovascular morbidity and mortality.
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              Korea hypertension fact sheet 2018

              Background The Korea Hypertension Fact Sheet 2018 aims to overview the magnitude and management status of hypertension, and their trends in Korea. Methods The Hypertension Epidemiology Research Group analyzed the 1998–2016 Korea National Health and Nutrition Examination Survey data and the 2002–2016 Korea National Health Insurance Big Data. Results The population average of systolic/diastolic blood pressure was 118/77 mmHg among Korean adults (age 30+) in 2016, showing little change in recent 10 years. However, the number of people with hypertension increased steadily, exceeding 11 million. The number of people diagnosed with hypertension increased from 3 million in 2002 to 8.9 million in 2016. The number of people using antihypertensive medication increased from 2.5 million in 2002 to 8.2 million in 2016. However, only 5.7 million people are being treated constantly. Hypertension awareness, treatment, and control rates increased fast until 2007, but showed a plateau thereafter. More than half of the young hypertensive patients (30–49 years) did not know about and treat for their hypertension. Among patients prescribed antihypertensive medications, 45% was elderly people over the age of 65 years, 57% used anti-diabetic or cholesterol-lowering medications, and 60% were prescribed two or more class of antihypertensive medications simultaneously. Conclusions In Korea, the level of hypertension management has considerably improved over the last 20 years. In order to achieve further improvement in hypertension management status, we need to find the vulnerable subgroups and develop subgroup-specific intervention strategies. It is also becoming more important to manage hypertensive patients at older age and those with concurrent chronic diseases. Electronic supplementary material The online version of this article (10.1186/s40885-018-0098-0) contains supplementary material, which is available to authorized users.
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                Author and article information

                Journal
                Korean Circ J
                Korean Circ J
                KCJ
                Korean Circulation Journal
                The Korean Society of Cardiology
                1738-5520
                1738-5555
                November 2019
                03 June 2019
                : 49
                : 11
                : 1035-1048
                Affiliations
                [1 ]Department of Public Health, Yonsei University Graduate School, Seoul, Korea.
                [2 ]Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
                [3 ]Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
                [4 ]Division of Cardiology, Ewha Womans University Mokdong Hospital, Seoul, Korea.
                [5 ]Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea.
                Author notes
                Correspondence to Hyeon Chang Kim, MD, PhD. Department of Preventive Medicine, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. hckim@ 123456yuhs.ac
                Author information
                https://orcid.org/0000-0003-2460-3335
                https://orcid.org/0000-0002-5034-8422
                https://orcid.org/0000-0002-6377-0411
                https://orcid.org/0000-0001-7867-1240
                Article
                10.4070/kcj.2019.0049
                6813160
                31190479
                dd8948d8-4b13-4d58-b9b4-c2e7efc50dff
                Copyright © 2019. The Korean Society of Cardiology

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 07 February 2019
                : 27 March 2019
                : 16 May 2019
                Categories
                Original Article

                Cardiovascular Medicine
                hypertension,blood pressure,chronic disease
                Cardiovascular Medicine
                hypertension, blood pressure, chronic disease

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