Progression Rate From New-Onset Pre-Hypertension to Hypertension in Korean Adults

Kim, Soo Jeong; Lee, Jakyoung; Nam, Chung Mo; Jee, Sun Ha; Park, Il Soo; Lee, Kyung Jong; Lee, Soon Young

doi:10.1253/circj.cj-09-0948

Cited by 25 publications

(8 citation statements)

References 22 publications

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“…Births are determined by the female population between ages 15 to 49 and fertility rate [47, 48]; while deaths are determined by age-specific mortality rate from life tables [47]. The transition from normal blood pressure to prehypertension [incidence of prehypertension], prehypertension to normal blood pressure [regression of prehypertension] and prehypertension to hypertension [incidence of hypertension] are determined by transition rates derived from current literature [51–53]. The prehypertension population increases by incidence of prehypertension and decreases by deaths and transition from prehypertension to hypertension and prehypertension to normal blood pressure.…”

Section: Methodsmentioning

confidence: 99%

An evaluation of the impact of aggressive hypertension, diabetes and smoking cessation management on CVD outcomes at the population level: a dynamic simulation analysis

Ansah¹,

Inn²,

Ahmad³

2019

BMC Public Health

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Background Evidence from randomized control trials suggest that coupled with smoking cessation interventions, CVD events can be reduced significantly if hypertension and diabetes patients are properly managed, raising practical what-if questions at the population level. This research aims to develop a dynamic simulation model using the systems modelling methodology of system dynamics, to evaluate the medium to long-term impact of hypertension and diabetes management, as well as smoking cessation intervention on CVD events, CVD deaths and post-CVD population. Methods The systems modelling methodology of system dynamics was used to develop a simulation model to evaluate the impact of aggressive hypertension, diabetes and smoking cessation management on CVD outcomes at the population level. Result The insights from this research suggest that despite that at the individual level, hypertension management is associated with the highest risk reduction for CVD (50%) compared to diabetes and smoking (20%) and is also the most prevalent risk factor, at the population level, diabetes management interventions are projected to have higher impact on reducing CVD events compared to hypertension management or smoking cessation interventions. However, a combined intervention of diabetes and hypertension management, as well as smoking cessation has the most impact on CVD outcomes. Conclusion Due to aging population and the increasing prevalence of chronic conditions in Singapore, the number of CVD events in Singapore is projected to rise significantly in the near future—hence the need for proactive planning to implement needed interventions. Findings from this research suggest that CVD events and its associated deaths and disabilities could be reduced significantly if diabetes and hypertension patients are aggressively managed. Electronic supplementary material The online version of this article (10.1186/s12889-019-7429-2) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

An evaluation of the impact of aggressive hypertension, diabetes and smoking cessation management on CVD outcomes at the population level: a dynamic simulation analysis

Ansah¹,

Inn²,

Ahmad³

2019

BMC Public Health

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“…15 In addition, the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) 15 in the United States defined prehypertension as BP of 120-139/80-89 mmHg, based on the evidence of a modest increase in CVD risk among individuals with such BP levels. In Asia, prehypertension was shown to be a predisposing factor for future hypertension, 20 and furthermore, there have been several studies that have confirmed the direct association between prehypertension and the risk of CVD.…”

Section: Hypertensionmentioning

confidence: 98%

Epidemiology of Stroke and Coronary Artery Disease in Asia

Hata

Kiyohara

2013

Circ J

163

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Stroke and coronary artery disease (CAD) are major causes of death throughout the world. As half of the world's population lives in Asian countries, prevention of stroke and CAD in Asia is crucial. According to the vital statistics, East Asian countries have a lower mortality rate for CAD than for stroke. In contrast, CAD is a more common cause of death than stroke in other Asian countries and Western countries. Hypertension, diabetes, hypercholesterolemia, and smoking are major risk factors for stroke and CAD in Asia as well as in Western countries. In an observational study in Japan, the stroke incidence decreased as a result of improvements in blood pressure control and reduction in the smoking rate over the past half century, whereas the CAD incidence did not show a clear secular change, probably because the benefits of blood pressure control and smoking cessation were negated by increasing prevalence of both glucose intolerance and hypercholesterolemia. Although Asian populations have lower serum cholesterol levels than Western populations, the prevalence of hypercholesterolemia has increased during the past half century in Asia. In addition, the smoking rate among Asian men is higher than for Western men. These results underscore that, in addition to blood pressure control, smoking cessation and the management of metabolic risk factors are very important for prevention of stroke and CAD in Asia. (Circ J 2013; 77: 1923 -1932

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“…For example, in the KMIC study, the risk of coronary artery disease was 2.51-fold higher in the stage 2 prehypertension group than in the stage 1 prehypertension group [6,7] . In addition, the probability of progressing to hypertension and the risk for a cardiovascular event were both reported to be higher in the prehypertension group than in the normal BP group [8][9][10] . In another paper from the KMIC study, a BP >135/85 mm Hg was associated with the occurrence of hemorrhagic stroke in male subjects.…”

Section: Office Bp-centered Approach and Subdivision Of The Prehypertmentioning

confidence: 99%

The Korean Society of Hypertension Guidelines for the Management of Hypertension in 2013: Its Essentials and Key Points

Lee

Park

2015

Pulse

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The Korean Society of Hypertension published new guidelines for the management of hypertension in 2013 which fully revised the first Korean hypertension treatment guideline published in 2004. Due to shortage of Korean data, the Committee decided to establish the guideline in the form of an 'adaptation' of the recently released guidelines. The prevalence of hypertension was 28.5% in the recent Korean National Health and Nutrition Examination Survey in 2011, and the awareness, treatment, and control rates are generally improving. However, the risks for cerebrovascular disease and coronary artery disease which are attributable to hypertension were the highest in Korea. The classification of hypertension is the same as in other guidelines. The remarkable difference is that prehypertension is further classified as stage 1 and 2 prehypertension because the cardiovascular risk is significantly different within the prehypertensive range. Although the decision-making was based on office blood pressure (BP) measured by the auscultation method using a stethoscope, the importance of home BP measurement and ambulatory BP monitoring is also stressed. The Korean guideline does not recommend a drug therapy in patients within the prehypertensive range, even in patients with prediabetes, diabetes mellitus, stroke, or coronary artery disease. In an elderly population over 65 years old, drug therapy can be initiated when the systolic BP (SBP) is ≥ 160 mm Hg. The target BP is generally an SBP of <140 mm Hg and a diastolic BP (DBP) of <90 mm Hg regardless of previous cardiovascular events. However, in patients with hypertension and diabetes, the lower DBP control <85 mm Hg is recommended. Also, in patients with hypertension with prominent albuminuria, a more strict SBP control <130 mm Hg can be recommended. In lifestyle modification, sodium reduction is the most important factor in Korea. Five classes of antihypertensive drugs, including angiotensin-converting enzyme inhibitors, β-blockers, calcium antagonists, and diuretics, are equally recommended as a first-line treatment, whereas a combination therapy chosen from renin-angiotensin system inhibitors, calcium antagonists, and diuretics is preferentially recommended.

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Progression Rate From New-Onset Pre-Hypertension to Hypertension in Korean Adults

Cited by 25 publications

References 22 publications

An evaluation of the impact of aggressive hypertension, diabetes and smoking cessation management on CVD outcomes at the population level: a dynamic simulation analysis

An evaluation of the impact of aggressive hypertension, diabetes and smoking cessation management on CVD outcomes at the population level: a dynamic simulation analysis

Epidemiology of Stroke and Coronary Artery Disease in Asia

The Korean Society of Hypertension Guidelines for the Management of Hypertension in 2013: Its Essentials and Key Points

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