• Journal of Preventive Medicine and Public Health
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• v.44 no.2
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• pp.74-83
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• 2011

Objectives: This study aimed to identify and assess the factors related to the awareness, treatment, and control of hypertension based on jurisdictional areas of primary health care posts in a rural community of Korea. Methods: This study was performed on 4598 adults aged over 30 years in a rural community and we measured their blood pressure (BP) from October. 2007 to August. 2009. Hypertension is defined as a condition characterized by a systolic BP ${\geq}$ 140 mmHg, a diastolic BP ${\geq}$ 90 mmHg or reported treatment with antihypertensive medications. We analyzed the factors related with the prevalence, awareness, treatment and control of hypertension using chi-square test and multivariate logistic regression analysis. Results: The age-adjusted prevalence of hypertension was 34.7%. The age-adjusted rates of hypertension awareness, treatment and control were 50.6%, 93.9% and 64.1%, respectively. Awareness of hypertension was related with increasing age. Higher awareness was found among men who were felt more stress, were obese and had hypercholesterolemia, and among women who were regulary taking medicine for hypertension, were obese and had diabetes mellitus. In women, the hypertension treatment was related a Medical aid and education for hypertension management. Controlled hypertension was more common among men who were educated about the management of hypertension and among women who had hypercholesterolemia. Conclusions: The awareness of hypertension was low and the control of hypertension was high compared with the nationwide data (KNHANES 2005). The results suggest that understanding the characteristics of hypertension in a community is important to perform a community based hypertension control program.

• Health Policy and Management
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• v.24 no.2
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• pp.136-142
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• 2014

Background: This study is to research on how hypertension control is associated with adherence in newly diagnosed hypertension patients. Methods: The study is based on 255,916 patients who were diagnosed with hypertension in 2009 and didn't have any previous medical history of hypertension or associated complication for the past year using data collected by National Health Insurance Corporation. Newly diagnosed hypertension patients are divided into two group by visiting medical center numbers (more than 300 days was adherence group, if not non-adherence group). Patients are considered to have successfully controlled their hypertension based on blood pressure measured by health examination. Chi-square test and logistic regression, repeated measured analysis of variance was used to analyze. Results: The relations between adherence and hypertension control show that 1.12 times of patients in adherence group was able to control their hypertension. The additional analysis proves that adherence group are more decreased level of blood pressure than non-adherence group except for patients who are over 70. Comparison of the average of systolic blood pressure and diastolic blood pressure between adherence and non-adherence groups shows that the blood pressure has been significantly among the adherence group. Conclusion: The study proves that constant treatment for hypertension could control the blood pressure and encourages patients to put more effort for persistent treatment. It also shows that hypertension treatment are more effective in younger patients than the elderly and strategies of approaching are different depending on age.

• Research in Community and Public Health Nursing
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• v.15 no.3
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• pp.385-396
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• 2004

Purpose: Hypertension has been a major cause of death in Korea since the 1970s, and has resulted in being a significant economic burden to the finances of national health care. The Ministry of Health and Welfare made several efforts. but hypertension control programs in Korea are still non standardized and ineffective. We wanted to investigate the current hypertension control program in public health centers systematically and suggest the direction for future programs. Method: The design of this study is a cross sectional investigation. From September to October in 2002, we sent a set of questionnaires to all PHCs, and 179 centers responded (response rate = 74.0%). The instrument was developed based on components of National health systems. Results: 1) Resources: The department responsible for hypertension control programs is the Department of Health Promotion. Health Education Center, Community Health Center, Citizen's Health Center, etc. The chief personnel of those departments are nurses. but 27.4% of PHCs have no full time nurse for hypertension management programs. PHCs had a lot of teaching materials (nine types per a PHC) and most of the recommended contents were included. But, periodical evaluation and revision were not being made, 2) Management: Nurses' (13.03 9.46 in 23 score) actions for hypertension control were not qualitative, but regular training and evaluation were seldom carried out. Need assessment (25.9%) and evaluation (about 10-20%) for the hypertension control program were indicated as low. 3) Programs: Programs focused on individuals rather than community or public, and 2nd prevention rather than 1st, 3rd prevention. Conclusion: The Ministry of Health and Welfare has to construct the infrastructure for hypertension control programs. Related scholars and committees should develop and declare standardized manuals for hypertension control and the management system, as well.

• Journal of Preventive Medicine and Public Health
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• v.48 no.1
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• pp.38-47
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• 2015

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.

• Journal of Preventive Medicine and Public Health
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• v.36 no.3
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• pp.263-270
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• 2003

Objectives : To identify the factors related to awareness, treatment, and control of hypertension in a Gwacheen population. Methods : This study surveyed 1,176 Gwacheon residents older than 40 years, and measured blood pressure using a standardized guideline in 1999. The study subjects were 473 adults (175 males, 295 females) with hypertension defined as a systolic blood pressure $\geq$140 mmHg, diastolic blood pressure $\geq$90 mmHg or reported treatment with antihypertensive medication. Information on awareness, treatment, and control of hypertension, and sociodemographic and health-related factors .was collected through person-to-person interviews with a structured questionnaire. Results : Overall, 252 (53.3%) of hypertensive subjects were aware of their condition, of whom as many as 193 (76.6%) were being treated, and 81 (42.0%) had their blood pressure controlled at the recommended level (<140/90 mmHg). However, of the 473 subjects found to have hypertension, only 40.8% were being treated, and 17.1% were under control. There were no significant differences in the proportions of awareness, treatment, and control of hypertension. In multiple logistic regression models, awareness of hypertension was positively associated with age and family history of hypertension in females. Control of hypertension was also positively associated with haying a partner and marital status in females.. Conclusion : These findings demonstrate that much greater efforts on improving awareness, treatment, and control of hypertension are needed, even in urban community settings, considering related factors such as a9e, family history, and marital status. However, these factors should be further investigated for their causal relationship.

• Journal of Preventive Medicine and Public Health
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• v.46 no.6
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• pp.353-359
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• 2013

Objectives: We examined the trends in prevalence, awareness, treatment, and control of hypertension in Korea as a basis for improving hypertension control programs. Methods: 12 598 participants of the Korean National Health and Nutrition Examination Survey were included in this study. Weighted linear regression to test time trends from 2007 to 2011 was performed. Results: The prevalence of hypertension was 20.7% in 2007, 29.4% in 2009, and 26.2% in 2011. Awareness of hypertension was 64.8% in 2007 and 61.1% in 2011. Awareness in those aged 65 and over was greater than in younger groups (age 19 to 44 and 45 to 64; p<0.001). The treatment rates were 58.4% in 2007 and 56.8% in 2011. The treatment rate was greater for those 65 and over than for younger age groups (p<0.001). The percentage of controlled hypertension was 37.6% in 2011. The percentage of controlled hypertension in those 65 and over was higher than in younger age groups (p<0.001). The treatment-control rates were 65.9% in 2007 and 67.7% in 2011. The prevalence of hypertension was higher in the males (p<0.001), while the awareness (p<0.001), treatment (p<0.001), and control (p<0.001) rates were higher in the females. Conclusions: The prevalence of hypertension was increasing and the hypertension awareness, treatment, and control rates were low in younger age groups and males.

• Research in Community and Public Health Nursing
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• v.5 no.2
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• pp.162-180
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• 1994

The control of the chronic degenerative diseases becomes a challenge in Korea as the aging of the population progresses. Accordingly, the importance of the control of the hypertension, one of the major chronic degenerative diseases, in the primary health care settings increases. However, such control activities are still minimal. This study gives brief description of how the rural residents who are currently registered for the control of the hypertension feel about the activities of the health centers, subcenters and the CHP posts, in relation to the control of the hypertension. We also describe the knowledge and practice of the registered hypertensive. In general, the knowledge, the acceptance and the satisfaction of the respondents about the hypertension control activities were not very high. Respondents being managed by the health center showed the highest knowledge, acceptance and satisfaction, and those being managed by the subcenters ranked lowest. The knowledge about the hypertension was not satisfactory. There were great variations among the items in terms of the proportion answered correctly. As many as 60% of the respondents take medication regularly but only 4.5% were practicing weight control regularly. Despite some limitations of the study, the results can be very useful for those planning hypertension control programs. The educational materials and the dietary protocols need to be developed in accordance with the regional social and food pattern, so that they can be utilized with minimal modification for each beneficiary. We also suggest to minimize the area a health personnel covers. In other word, running several small health posts at village level would be more effective than running a subcenter at the township level, in terms of the hypertension control.

• Journal of Preventive Medicine and Public Health
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• v.33 no.4
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• pp.513-520
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• 2000

Objectives : To estimate the prevalence of hypertension, rates of awareness, treatment modalities, and control of hypertension, and also to identify factors in rural Korea that are related to these aspects of hypertension. Methods : A cross-sectional survey, including blood pressure(BP) measurements and interviews, investigating the variables in the health belief model was peformed from August to November, 1999 on 1,426 (79.4%) study subjects out of 1,797 registered residents over 30 years old in Ibansong-Myun, Chinju City. A second survey was peformed from January to March, 2000 on 376 (80.0%) subjects out of 470 hypertensive (or suspected hypertensive) subjects found in the first survey. Two BP readings were taken in each survey using a standard mercury sphygmomanometer. Hypertension was defined as either a BP reading $\geq$ 140/90 mmHg in both surveys, or as subjects on oral hypertensive medication. Results : Estimated hypertension prevalence was 24.9% for men, and 30.4% for women. Rates of hypertension awareness, treatment (the regular use of oral hypertensives), and control (reduction of BP to <140/90 mmHg) were 52.5%, 34.4%, and 12.9%, respectively. The factors related to lower hypertension awareness in the logistic regression analysis were male gender, farming occupation, and higher perceived barrier to medical treatment (those for whom visiting health professionals is a burden). Conclusions : To improve the low awareness, treatment, and control of hypertension, a more active and out-reaching hypertension control program, including routine BP measurements for every visitor to primary care facilities, is needed in rural Korea.

• Research in Community and Public Health Nursing
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• v.17 no.4
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• pp.441-450
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• 2006

Purpose: The purposes of this study were to identify variables related to self-care behavior and to find factors related to the control of hypertension. A cross-sectional study was carried out to provide basic data for effective and continuous hypertension control in the low-income elderly. Methods: This study was performed with a total of 189 subjects who were hypertensive and were receiving pharmacological treatment of hypertension from a community health center in D Metropolitan City. Data were collected through a face to face survey, and systolic and diastolic blood pressure (the mean value of the two measures) were measured during May 2004. Obtained data were analyzed by $x^2$ test, t-test, multiple logistic regression and Pearson's correlation coefficient (using SPSS Version 10.1). Results: 1. According to demographical characteristics, the score of self-care behavior was significantly higher in elders living along ($47.63{\pm}7.276$) than in those living with the family ($45.19{\pm}5.501$) (p<.05), and in those with religion ($47.11{\pm}6.722$) than in those without religion ($45.01{\pm}6.110$) (p<.05) 2. As to blood pressure control, the percentage of blood pressure control within the normal range (systolic 140mmHg, diastolic below 90mmHg) was 37.03%. According to demographical characteristics, the percentage of blood pressure control was significantly lower in those without religion (p<.05). In practicing hypertension self-care behavior, those who do not control salk intake showed a significantly lower percentage of hypertension control (p<.05). The score of hypertension self-care was $48.28{\pm}4.443$ in the controlled group, and $45.42{\pm}7.399$ in the uncontrolled group, showing a significant difference (p<.01). 3. Hypertension self-care behavior was in a positive correlation with blood pressure control (r=.210, p<.05). Conclusion: Attention should be paid to self-care behavior to increase the control of hypertension in the low-income elderly. These results can be used guidances for improving self-care behavior and the control of hypertension in the low-income elderly.

• Health Policy and Management
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• v.3 no.2
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• pp.25-56
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• 1993

Hypertension has already become a serious health problem in many countries. Treatment is effective, however, and the detection and long-term management of those at risk pose sustained challenges. Community programs can be an important strategy for primary prevention of hypertention and for monitoring the progress and promoting compliance of hypertensive patients. Hwachon Health Demonstrain Project has designed community hypertention control program, especially emphasizing role of public health sector, and operate that model from 1990 at Hwachon county, Kwangwon province. This paper appraise the effectiveness of curent activities. Many paper appraise the effectiveness of curent activities. Many hypertensive persons who have not recognized his disease were identified and began hypertension treatment. However about two thirds of patients have not complied continuously with medical advice. Consequently, the project team redirects its efforts. Less emphasis is being placed screening and identification of patients, while more emphasis is being placed on increasing compliance with treatment recommendations. Some approches to improve hypertension control program are also discussed in the context of the field experience and literature on this suvjest.