Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
권호 표지
DOI QR코드

DOI QR Code

Prevalence and Trends of Isolated Systolic Hypertension among Korean Adults: the Korea National Health and Nutrition Examination Survey, 1998-2012

  • Kim, Na Rae (Department of Public Health, Yonsei University Graduate School) ;
  • Kim, Hyeon Chang (Department of Preventive Medicine, Yonsei University College of Medicine)
  • Received : 2014.11.16
  • Accepted : 2015.06.02
  • Published : 2015.11.30
⟨ Previous Next ⟩

Abstract

Background and Objectives: Systolic and diastolic blood pressure may have different effects on cardiovascular disease, but limited data is available for hypertension subtypes in the Korean population. Thus, the prevalence, and absolute number of hypertension subtypes among Korean adults was estimated. Subjects and Methods: The Korea National Health and Nutrition Examination Survey 1998-2012 was used to estimate the prevalence and absolute number of each hypertension subtype among Korean adults aged ${\geq}20years$. Hypertension was classified into four subtypes: treated hypertension (TH), isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and combined systolic and diastolic hypertension (SDH). Results: In 2012, approximately 9.5 million adults were estimated to have hypertension, which consists of 5675671 TH (60.0%), 954253 ISH (10.1%), 1649486 IDH (17.4%), and 1175506 SDH (12.4%). Between 2010 and 2012, the proportion of IDH steadily decreased with age, but ISH increased especially in older ages (${\geq}40$). Between 1998 and 2012, TH markedly increased from 1.4 million to 5.7 million while the number of untreated hypertension remained relatively constant. During the same time, the number of hypertensive elderlies increased from 507000 to 2822000 along with rapid ageing of the Korean population. Despite of significant improvement in treatment rate, there are still around 583000 elderlies with untreated hypertension (423000 ISH; 42000 IDH; 118000 SDH) as of 2012. Conclusion: Although the prevalence of hypertension has been constant over the last decades, absolute number of people with hypertension has been increasing. Along with the rapid population ageing, the number of elderly hypertension is increasing and the ISH is also becoming more prevalent.

Keywords

Acknowledgement

Supported by : Ministry of Health & Welfare

References

  1. Murray CJ, Lopez AD. Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet 1997;349:1269-76. https://doi.org/10.1016/S0140-6736(96)07493-4
  2. Sekikawa A, Kuller LH, Ueshima H, et al. Coronary heart disease mortality trends in men in the post World War II birth cohorts aged 35-44 in Japan, South Korea and Taiwan compared with the United States. Int J Epidemiol 1999;28:1044-9. https://doi.org/10.1093/ije/28.6.1044
  3. Statistics Korea. 2012 statistics for cause of death [Internet]. [Accessed on Oct 2, 2015]. Available from: http://kostat.go.kr/portal/korea/kor_nw/3/index.board?bmode=read&aSeq=308560.
  4. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002;360:1903-13. https://doi.org/10.1016/S0140-6736(02)11911-8
  5. Korea Health Statistics 2012: Korea National Health and Nutrition Examination Survey (KNHANES V-3). Ministry of Health and Welfare. [Internet]. [Accessed on Oct 2, 2015]. Available from: https://knhanes.cdc.go.kr/knhanes/index.do.
  6. Medical Service Usage Statistics by Region. 2012. National Health Insurance Corporation. [Internet]. [Accessed on Oct 2, 2015]. Available from: http://www.nhis.or.kr/bbs7/boards/B0076?.
  7. Garland C, Barrett-Connor E, Suarez L, Criqui MH. Isolated systolic hypertension and mortality after age 60 years. A prospective population-based study. Am J Epidemiol 1983;118:365-76. https://doi.org/10.1093/oxfordjournals.aje.a113644
  8. National High Blood Pressure Education Program Working Group Report on hypertension in the elderly. National High Blood Pressure Education Program Working Group. Hypertension 1994;23:275-85. https://doi.org/10.1161/01.HYP.23.3.275
  9. Asmar R. Benefits of blood pressure reduction in elderly patients. J Hypertens Suppl 2003;21:S25-30.
  10. Kannel WB, Gordon T, Schwartz MJ. Systolic versus diastolic blood pressure and risk of coronary heart disease. The Framingham study. Am J Cardiol 1971;27:335-46. https://doi.org/10.1016/0002-9149(71)90428-0
  11. Antikainen R, Jousilahti P, Tuomilehto J. Systolic blood pressure, isolated systolic hypertension and risk of coronary heart disease, strokes, cardiovascular disease and all-cause mortality in the middleaged population. J Hypertens 1998;16:577-83. https://doi.org/10.1097/00004872-199816050-00004
  12. Franklin SS, Gustin W 4th, Wong ND, et al. Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study. Circulation 1997;96:308-15. https://doi.org/10.1161/01.CIR.96.1.308
  13. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group. JAMA 1991;265:3255-64. https://doi.org/10.1001/jama.1991.03460240051027
  14. Burt VL, Whelton P, Roccella EJ, et al. Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988-1991. Hypertension 1995;25:305-13. https://doi.org/10.1161/01.HYP.25.3.305
  15. Huang J, Wildman RP, Gu D, Muntner P, Su S, He J. Prevalence of isolated systolic and isolated diastolic hypertension subtypes in China. Am J Hypertens 2004;17:955-62. https://doi.org/10.1016/j.amjhyper.2004.06.007
  16. Kim JA, Kim SM, Choi YS, et al. The prevalence and risk factors associated with isolated untreated systolic hypertension in Korea: the Korean National Health and Nutrition Survey 2001. J Hum Hypertens 2007;21:107-13. https://doi.org/10.1038/sj.jhh.1002119
  17. Kim BG, Park JT, Ahn Y, Kimm K, Shin C. Geographical difference in the prevalence of isolated systolic hypertension in middle-aged men and women in Korea: the Korean Health and Genome Study. J Hum Hypertens 2005;19:877-83. https://doi.org/10.1038/sj.jhh.1001904
  18. Choi SW, Kim MK, Han SW, et al. Characteristics of hypertension subtypes and treatment outcome among elderly Korean hypertensives. J Am Soc Hypertens 2014;8:246-53. https://doi.org/10.1016/j.jash.2014.01.004
  19. Kweon S, Kim Y, Jang MJ, et al. Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES). Int J Epidemiol 2014;43:69-77. https://doi.org/10.1093/ije/dyt228
  20. Vasan RS, Massaro JM, Wilson PW, et al. Antecedent blood pressure and risk of cardiovascular disease: the Framingham Heart Study. Circulation 2002;105:48-53. https://doi.org/10.1161/hc0102.101774
  21. Nwankwo T, Yoon SS, Burt V, Gu Q. Hypertension among adults in the United States: National Health and Nutrition Examination Survey, 2011-2012. NCHS Data Brief 2013;(133):1-8.
  22. Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics--2013 update: a report from the American Heart Association. Circulation 2013;127:e6-245. https://doi.org/10.1161/CIR.0b013e31828124ad
  23. Egan BM, Zhao Y, Axon RN. US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA 2010;303:2043-50. https://doi.org/10.1001/jama.2010.650
  24. Tran CL, Ehrmann BJ, Messer KL, et al. Recent trends in healthcare utilization among children and adolescents with hypertension in the United States. Hypertension 2012;60:296-302. https://doi.org/10.1161/HYPERTENSIONAHA.111.188813
  25. Kissela BM, Khoury JC, Alwell K, et al. Age at stroke: temporal trends in stroke incidence in a large, biracial population. Neurology 2012;79:1781-7. https://doi.org/10.1212/WNL.0b013e318270401d
  26. Joffres MR, Hamet P, MacLean DR, L’Italien GJ, Fodor G. Distribution of blood pressure and hypertension in Canada and the United States. Am J Hypertens 2001;14(11 Pt 1):1099-105. https://doi.org/10.1016/S0895-7061(01)02211-7
  27. Wilking SV, Belanger A, Kannel WB, D’Agostino RB, Steel K. Determinants of isolated systolic hypertension. JAMA 1988;260:3451-5. https://doi.org/10.1001/jama.1988.03410230069030
  28. Martins D, Nelson K, Pan D, Tareen N, Norris K. The effect of gender on age-related blood pressure changes and the prevalence of isolated systolic hypertension among older adults: data from NHANES III. J Gend Specif Med 2001;4:10-3, 20.
  29. Franklin SS, Jacobs MJ, Wong ND, L’Italien GJ, Lapuerta P. Predominance of isolated systolic hypertension among middle-aged and elderly US hypertensives: analysis based on National Health and Nutrition Examination Survey (NHANES) III. Hypertension 2001;37:869-74. https://doi.org/10.1161/01.HYP.37.3.869
  30. Jennrich R. Age-specific relevance of usual blood pressure to vascular mortality. Lancet 2003;361:1390-1; author reply 1-2. https://doi.org/10.1016/S0140-6736(03)13061-9

Cited by

  1. Epidemiological studies in hypertension: more relevant than ever vol.30, pp.4, 2016, https://doi.org/10.1038/jhh.2016.2
  2. Prevalence of arterial hypertension in the Krasnoyarsk Krai (Siberia, Russia) vol.17, pp.None, 2015, https://doi.org/10.1186/s12872-017-0559-5
  3. Vasorelaxant and Hypotensive Effects of Cheonwangbosimdan in SD and SHR Rats vol.2018, pp.None, 2018, https://doi.org/10.1155/2018/6128604
  4. Hypertension and its Correlates in the Oldest Old Population Aged 80 Years and Above in Urban South India vol.7, pp.3, 2015, https://doi.org/10.4172/2167-7182.1000472
  5. Changes of computed tomography‐based body composition after adrenalectomy in patients with endogenous hypercortisolism vol.90, pp.2, 2019, https://doi.org/10.1111/cen.13902
  6. 미세먼지와 오존노출에 의한 노인의 의료 이용 영향에 대한 연구 vol.45, pp.1, 2019, https://doi.org/10.5668/jehs.2019.45.1.30
  7. Elderly Mortality and Exposure to Fine Particulate Matter and Ozone vol.34, pp.48, 2019, https://doi.org/10.3346/jkms.2019.34.e311
  8. Blood pressure and hypertension prevalence among oldest-old in China for 16 year: based on CLHLS vol.19, pp.1, 2015, https://doi.org/10.1186/s12877-019-1262-4
  9. Blood pressure and hypertension prevalence among oldest-old in China for 16 year: based on CLHLS vol.19, pp.1, 2015, https://doi.org/10.1186/s12877-019-1262-4
  10. Differences in prevalence of hypertension subtypes according to the 2018 Korean Society of Hypertension and 2017 American College of Cardiology/American Heart Association guidelines: The Korean Nation vol.25, pp.1, 2019, https://doi.org/10.1186/s40885-019-0129-5
  11. Trends in the prevalence of hypertension according to severity and phenotype in Chinese adults over two decades (1991‐2015) vol.23, pp.7, 2015, https://doi.org/10.1111/jch.14306