In the current study, the association of new BP categories with risk of incident CVD was more evident in young adults aged <40 years than in the older subjects, which is in line with earlier studies that also reported a stronger association between BP and CVD outcomes in middle?aged compared with elderly populations. 8 , 46 , 51 , 52 , 53 The reasons for the stronger associations in young adults are unclear.
The effect away from BP toward risk of CVD tends to be diluted that have growing decades since the the incidence away from high BP and other CVD risk factors in addition to be more common as we age
When you look at the Southern Korea, this new Korean Community off Blood pressure computed to make use of the previous blood pressure level requirements out of systolic BP/diastolic BP ? mm Hg due to insufficient obvious research for additional take advantage of decreasing the blood circulation pressure endurance to mm Hg to own Koreans. 54 , 55 According to the Korean Hypertension Facts Piece 2018, the number of some one identified as having hypertension enhanced of step three billion inside 2002 to 8.nine mil when you look at the 2016, in just 5.eight million those with compatible and you will chronic antihypertensive cures into the 2016. 56 The treatment price improved off twenty-two% for the 1998 in order to 59% from inside the 2007 in order to 61% into the 2016, in addition to control speed enhanced off 5% inside 1998 to help you 41% for the 2007 in order to 49% during the 2016. 56 For the research conducted recently by using the Korean Federal Health and Diet Test Questionnaire, the fresh prevalence out of blood pressure levels plus the number of people who need antihypertensive therapy might be improved, are similar along with other nations. 55 , 57 , 58 Predicated on current degree addressing utilization of brand new guidelines into the numerous countries, like the All of us, Asia, and Korea, the newest 2017 ACC/AHA hypertension guidance have a pussysaga chat tendency to significantly help the incidence regarding blood pressure and you will what number of customers who need antihypertensive treatment initiation and people who are in need of procedures intensification around the globe. 57 , 58 , 59 , 60 , 61 , 62 In research conducted recently on the National Health and Diet Test Questionnaire, with respect to the 2017 ACC/AHA rule, compared with the new Seventh Mutual Federal Panel guideline, brand new prevalence out-of blood circulation pressure has increased from 29.9% to 45.6%, this new percentage of All of us adults recommended for antihypertensive cures has increased off 34.3% so you can thirty six.2%, and you will 53.4% folks people bringing antihypertensive therapy you would like even more extreme decline in their BP. 59 In the eventuality of China, use of your 2017 ACC/AHA hypertension recommendations create resulted in increment in the prevalence away from blood pressure level from twenty-five% in order to 50%. 63 It must be examined if the for example alterations in the brand new symptomatic tolerance and you may therapeutic targets out of in order to mm Hg carry out boost BP handle as well as relevant result. Future studies are together with needed seriously to establish the fresh new connection between BP and CVD exposure on young society which have varied ethnicity and you will to decide in case your exposure/benefit ratio to possess treatment solutions are advantageous inside lowest?chance category.
Age and you can gender standardization is did utilizing the lead strategy for the decades build of Korean society, old 20 in order to 80 years, in 2010
The strengths of our study are its cohort study design, the large sample size, the use of carefully standardized clinical procedures, and the almost complete follow?up for CVD events, as the National Health Insurance collects all medical services use covering the entire Korean population. This study also has several limitations. First, as with most previous studies, the determination of BP was based on a single?day measurement, although 3 readings were taken. Second, we did not incorporate changes in BP categories and other covariates during follow?up. Third, health behaviors were assessed via a self?administered structured questionnaire used in health checkup programs in Korea, as part of the National Health Insurance plan. Measurement errors in these variables may introduce some degree of residual confounding, similar to most epidemiologic studies. Fourth, we used the Pooled Cohorts Equations in all participants; however, it was not validated in adults aged <40 years. Finally, this is an opportunistic cohort of individuals, who self?presented for the health examination, and hence is not a representative sample of low cardiovascular risk young adults in the community. The study population of this cohort was relatively highly educated, young to middle?aged Korean adults with high accessibility to healthcare resources. We compared our study population with a representative sample of the general Korean population (the Korea National Health and Nutrition Examination Survey). The age? and sex?standardized prevalence of hypertension (defined as systolic BP ?140 mm Hg, diastolic BP ?90 mm Hg, or the use of antihypertensive medication), type 2 diabetes mellitus (defined as fasting serum glucose level ?126 mg/dL or the use of blood glucose–lowering agents), obesity (body mass index ?25 kg/m 2 ), and current smoker was lower than those of the general population (16.6% versus 29.1%, 9.3% versus 10.5%, 27.6% versus 31.5%, and 16.8% versus 26.5%, respectively), indicating that our study population may be healthier than the general Korean population. Thus, our findings might not be generalizable to other ethnic groups or populations with different age, demographic, diet, and health behavior characteristics.
