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 end result away from BP with the risk of CVD tends to be diluted with broadening age due to the fact both incidence from higher BP and you may most other CVD risk activities along with become more prevalent as we grow old
Inside South Korea, the Korean Area out of Blood pressure levels computed to use the last blood pressure criteria from systolic BP/diastolic BP ? mm Hg due to too little clear evidence for additional make use of lowering the blood circulation pressure threshold so you’re able to mm Hg for Koreans. 54 , 55 According to the Korean Blood pressure Truth Sheet 2018, exactly how many people diagnosed with blood pressure increased away from 3 million for the 2002 to 8.9 mil within the 2016, with just 5.eight million people with appropriate and you can chronic antihypertensive treatment for the 2016. 56 The treatment rate enhanced out of 22% from inside the 1998 to 59% into the 2007 and to 61% during the 2016, together with control price enhanced of 5% when you look at the 1998 to help you 41% into the 2007 in order to 44% from inside the 2016. 56 When you look at the a recent study utilizing the Korean Federal Health insurance and Nutrition Examination Survey, the new prevalence away from blood circulation pressure plus the level of people who require antihypertensive medication is enhanced, getting equivalent with other regions. 55 , 57 , 58 Based on latest training approaching utilization of the latest direction inside the numerous places, including the Us, Asia, and you www.datingranking.net/tr/seniorblackpeoplemeet-inceleme can Korea, brand new 2017 ACC/AHA blood pressure guidelines usually markedly improve the frequency of blood pressure levels and you will the amount of clients who are in need of antihypertensive cures initiation and those who need cures intensification global. 57 , 58 , 59 , sixty , 61 , 62 During the research conducted recently regarding the Federal Health and Diet Test Survey, according to the 2017 ACC/AHA guideline, in contrast to this new 7th Joint Federal Panel guideline, the new prevalence regarding blood circulation pressure has grown of 30.9% so you’re able to forty-five.6%, the new portion of United states adults suitable for antihypertensive procedures has grown from 34.3% to thirty-six.2%, and you will 53.4% people people bringing antihypertensive cures you need way more intense reduction in the BP. 59 In the event of China, adoption of your 2017 ACC/AHA blood pressure level guidance carry out lead to the increment on the incidence out of hypertension of twenty-five% to fifty%. 63 It ought to be evaluated if such as for instance changes in the new symptomatic endurance and you can therapeutic targets out of so you’re able to mm Hg manage raise BP control and its own related result. Future scientific studies are and wanted to confirm brand new association anywhere between BP and you will CVD chance in the younger population having varied ethnicity and to choose in the event your chance/work with ratio to own treatment solutions are good in this reduced?chance classification.
Age and you can intercourse standardization is actually did utilizing the head method on the decades design of your own Korean society, old 20 to help you 80 years, in the year 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.
