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Gender Differences in Hypertension Control Among Older Korean Adults: Korean Social Life, Health, and Aging Project

  • Chu, Sang Hui (Department of Clinical Nursing Science, Nursing Policy Research Institute, Yonsei University College of Nursing) ;
  • Baek, Ji Won (Department of Sociology, Yonsei University College of Social Sciences) ;
  • Kim, Eun Sook (Department of Nursing, Yonsei University Graduate School) ;
  • Stefani, Katherine M. (Department of Public Health, Yonsei University Graduate School) ;
  • Lee, Won Joon (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Park, Yeong-Ran (Division of Silver Industry, Kangnam University) ;
  • Youm, Yoosik (Department of Sociology, Yonsei University College of Social Sciences) ;
  • Kim, Hyeon Chang (Department of Preventive Medicine, Yonsei University College of Medicine)
  • Received : 2014.09.22
  • Accepted : 2014.12.08
  • Published : 2015.01.31

Abstract

Objectives: Controlling blood pressure is a key step in reducing cardiovascular mortality in older adults. Gender differences in patients' attitudes after disease diagnosis and their management of the disease have been identified. However, it is unclear whether gender differences exist in hypertension management among older adults. We hypothesized that gender differences would exist among factors associated with hypertension diagnosis and control among community-dwelling, older adults. Methods: This cross-sectional study analyzed data from 653 Koreans aged ${\geq}60years$ who participated in the Korean Social Life, Health, and Aging Project. Multiple logistic regression was used to compare several variables between undiagnosed and diagnosed hypertension, and between uncontrolled and controlled hypertension. Results: Diabetes was more prevalent in men and women who had uncontrolled hypertension than those with controlled hypertension or undiagnosed hypertension. High body mass index was significantly associated with uncontrolled hypertension only in men. Multiple logistic regression analysis indicated that in women, awareness of one's blood pressure level (odds ratio [OR], 2.86; p=0.003) and the number of blood pressure checkups over the previous year (OR, 1.06; p=0.011) might influence the likelihood of being diagnosed with hypertension. More highly educated women were more likely to have controlled hypertension than non-educated women (OR, 5.23; p=0.013). Conclusions: This study suggests that gender differences exist among factors associated with hypertension diagnosis and control in the study population of community-dwelling, older adults. Education-based health promotion strategies for hypertension control might be more effective in elderly women than in elderly men. Gender-specific approaches may be required to effectively control hypertension among older adults.

Keywords

References

  1. MacMahon S, Alderman MH, Lindholm LH, Liu L, Sanchez RA, Seedat YK. Blood-pressure-related disease is a global health priority. Lancet 2008;371(9623):1480-1482. https://doi.org/10.1016/S0140-6736(08)60632-7
  2. Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics: 2012 update: a report from the American Heart Association. Circulation 2012; 125(1):e2-e220. https://doi.org/10.1161/CIR.0b013e31823ac046
  3. Murray CJ, Lauer JA, Hutubessy RC, Niessen L, Tomijima N, Rodgers A, et al. Effectiveness and costs of interventions to lower systolic blood pressure and cholesterol: a global and regional analysis on reduction of cardiovascular-disease risk. Lancet 2003; 361(9359):717-725. https://doi.org/10.1016/S0140-6736(03)12655-4
  4. Ong KL, Tso AW, Lam KS, Cheung BM. Gender difference in blood pressure control and cardiovascular risk factors in Americans with diagnosed hypertension. Hypertension 2008;51(4): 1142-1148. https://doi.org/10.1161/HYPERTENSIONAHA.107.105205
  5. Chow CK, Teo KK, Rangarajan S, Islam S, Gupta R, Avezum A, et al. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. JAMA 2013;310(9):959-968. https://doi.org/10.1001/jama.2013.184182
  6. Korea Centers for Disease Control and Prevention. Korea health statistics 2012: Korea National Health and Nutritional Examination Survey (KNHANES V-3). Cheongju: Korea Centers for Disease Control and Prevention; 2013, p. 53-54, 623-624 (Korean).
  7. 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.
  8. Liu L, An Y, Chen M, Liu Z, Hu X, Chou E, et al. Trends in the prevalence of hospitalization attributable to hypertensive diseases among United States adults aged 35 and older from 1980 to 2007. Am J Cardiol 2013;112(5):694-699. https://doi.org/10.1016/j.amjcard.2013.04.050
  9. Chi MJ, Lee CY, Wu SC. Multiple morbidity combinations impact on medical expenditures among older adults. Arch Gerontol Geriatr 2011;52(3):e210-e214. https://doi.org/10.1016/j.archger.2010.11.013
  10. Beckett NS, Peters R, Fletcher AE, Staessen JA, Liu L, Dumitrascu D, et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med 2008;358(18):1887-1898. https://doi.org/10.1056/NEJMoa0801369
  11. Trevisol DJ, Moreira LB, Kerkhoff A, Fuchs SC, Fuchs FD. Health-related quality of life and hypertension: a systematic review and meta-analysis of observational studies. J Hypertens 2011; 29(2):179-188. https://doi.org/10.1097/HJH.0b013e328340d76f
  12. Gu Q, Burt VL, Paulose-Ram R, Dillon CF. Gender differences in hypertension treatment, drug utilization patterns, and blood pressure control among US adults with hypertension: data from the National Health and Nutrition Examination Survey 1999-2004. Am J Hypertens 2008;21(7):789-798. https://doi.org/10.1038/ajh.2008.185
  13. Yu HT, Kim KJ, Bang WD, Oh CM, Jang JY, Cho SS, et al. Gender-based differences in the management and prognosis of acute coronary syndrome in Korea. Yonsei Med J 2011;52(4):562-568. https://doi.org/10.3349/ymj.2011.52.4.562
  14. Chou AF, Scholle SH, Weisman CS, Bierman AS, Correa-de-Araujo R, Mosca L. Gender disparities in the quality of cardiovascular disease care in private managed care plans. Womens Health Issues 2007;17(3):120-130. https://doi.org/10.1016/j.whi.2007.03.002
  15. Os I, Oparil S, Gerdts E, Hoieggen A. Essential hypertension in women. Blood Press 2004;13(5):272-278. https://doi.org/10.1080/08037050410024330
  16. Gee ME, Bienek A, McAlister FA, Robitaille C, Joffres M, Tremblay MS, et al. Factors associated with lack of awareness and uncontrolled high blood pressure among Canadian adults with hypertension. Can J Cardiol 2012;28(3):375-382. https://doi.org/10.1016/j.cjca.2011.12.012
  17. Ostchega Y, Hughes JP, Wright JD, McDowell MA, Louis T. Are demographic characteristics, health care access and utilization, and comorbid conditions associated with hypertension among US adults? Am J Hypertens 2008;21(2):159-165. https://doi.org/10.1038/ajh.2007.32
  18. Gueyffier F, Boutitie F, Boissel JP, Pocock S, Coope J, Cutler J, et al. Effect of antihypertensive drug treatment on cardiovascular outcomes in women and men: a meta-analysis of individual patient data from randomized, controlled trials: the INDANA Investigators. Ann Intern Med 1997;126(10):761-767. https://doi.org/10.7326/0003-4819-126-10-199705150-00002
  19. Deeks A, Lombard C, Michelmore J, Teede H. The effects of gender and age on health related behaviors. BMC Public Health 2009; 9:213. https://doi.org/10.1186/1471-2458-9-213
  20. Youm Y, Laumann EO, Ferraro KF, Waite LJ, Kim HC, Park YR, et al. Social network properties and self-rated health in later life: comparisons from the Korean social life, health, and aging project and the national social life, health and aging project. BMC Geriatr 2014;14:102. https://doi.org/10.1186/1471-2318-14-102
  21. Lee JM, Lee WJ, Kim HC, Choi W, Lee J, Sung K, et al. The Korean social life, health and aging project-health examination cohort. Epidemiol Health 2014;36:e2014003. https://doi.org/10.4178/epih/e2014003
  22. Cornwell EY, Waite LJ. Social network resources and management of hypertension. J Health Soc Behav 2012;53(2):215-231. https://doi.org/10.1177/0022146512446832
  23. Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 2001;285(19):2486-2497. https://doi.org/10.1001/jama.285.19.2486
  24. Prince MJ, Ebrahim S, Acosta D, Ferri CP, Guerra M, Huang Y, et al. Hypertension prevalence, awareness, treatment and control among older people in Latin America, India and China: a 10/66 cross-sectional population-based survey. J Hypertens 2012;30(1):177-187. https://doi.org/10.1097/HJH.0b013e32834d9eda
  25. Han HR, Kim KB, Kang J, Jeong S, Kim EY, Kim MT. Knowledge, beliefs, and behaviors about hypertension control among middle-aged Korean Americans with hypertension. J Community Health 2007;32(5):324-342. https://doi.org/10.1007/s10900-007-9051-y
  26. Mosca L, Mochari H, Christian A, Berra K, Taubert K, Mills T, et al. National study of women's awareness, preventive action, and barriers to cardiovascular health. Circulation 2006;113(4): 525-534. https://doi.org/10.1161/CIRCULATIONAHA.105.588103
  27. Choi EJ, Jekal Y, Kim S, Yoo JS, Kim HS, Oh EG, et al. Middle-aged women's awareness of cholesterol as a risk factor: results from a national survey of Korean Middle-aged Women's Health Awareness (KomWHA) study. Int J Nurs Stud 2010;47(4):452-460. https://doi.org/10.1016/j.ijnurstu.2009.09.002
  28. Kim HJ, Ruger JP. Socioeconomic disparities in behavioral risk factors and health outcomes by gender in the Republic of Korea. BMC Public Health 2010;10:195. https://doi.org/10.1186/1471-2458-10-195
  29. Kim JA, Montagnani M, Koh KK, Quon MJ. Reciprocal relationships between insulin resistance and endothelial dysfunction: molecular and pathophysiological mechanisms. Circulation 2006;113(15):1888-1904. https://doi.org/10.1161/CIRCULATIONAHA.105.563213
  30. Cardillo C, Nambi SS, Kilcoyne CM, Choucair WK, Katz A, Quon MJ, et al. Insulin stimulates both endothelin and nitric oxide activity in the human forearm. Circulation 1999;100(8):820-825. https://doi.org/10.1161/01.CIR.100.8.820
  31. Lesniewski LA, Donato AJ, Behnke BJ, Woodman CR, Laughlin MH, Ray CA, et al. Decreased NO signaling leads to enhanced vasoconstrictor responsiveness in skeletal muscle arterioles of the ZDF rat prior to overt diabetes and hypertension. Am J Physiol Heart Circ Physiol 2008;294(4):H1840-H1850. https://doi.org/10.1152/ajpheart.00692.2007
  32. Abe H, Yamada N, Kamata K, Kuwaki T, Shimada M, Osuga J, et al. Hypertension, hypertriglyceridemia, and impaired endothelium-dependent vascular relaxation in mice lacking insulin receptor substrate-1. J Clin Invest 1998;101(8):1784-1788. https://doi.org/10.1172/JCI1594
  33. Arauz-Pacheco C, Parrott MA, Raskin P; American Diabetes Association. Treatment of hypertension in adults with diabetes. Diabetes Care 2003;26 Suppl 1:S80-S82. https://doi.org/10.2337/diacare.26.2007.S80
  34. James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 Evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014;311(5):507-520. https://doi.org/10.1001/jama.2013.284427
  35. Davarian S, Crimmins E, Takahashi A, Saito Y. Sociodemographic correlates of four indices of blood pressure and hypertension among older persons in Japan. Gerontology 2013;59(5): 392-400. https://doi.org/10.1159/000350531
  36. Douchi T, Kosha S, Uto H, Oki T, Nakae M, Yoshimitsu N, et al. Precedence of bone loss over changes in body composition and body fat distribution within a few years after menopause. Maturitas 2003;46(2):133-138. https://doi.org/10.1016/S0378-5122(03)00162-2
  37. Banegas JR, Segura J, Sobrino J, Rodriguez-Artalejo F, de la Sierra A, de la Cruz JJ, et al. Effectiveness of blood pressure control outside the medical setting. Hypertension 2007;49(1):62-68. https://doi.org/10.1161/01.HYP.0000250557.63490.55

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