A multicenter cohort study of primary hypertension in Korea: study design and interim analysis of the Korean registry of target organ damage in hypertension (KorHR)

Suk-Won Choi,Mi-Seung Shin,Jong Sun Ok,Seong Woo Han,Sung Ha Park,Kyu-Hyung Ryu,Byung-Su Yoo

doi:10.1186/s40885-017-0072-2

Abstract

BackgroundThe Korean Registry of Target Organ Damage in Hypertension aims to evaluate the clinical characteristics and prevalence of subclinical target organ damage in Korean hypertensive patients.MethodThis is a prospective, observational, multicenter cohort study in which 23 university hospitals participated. Since May 2013, we have enrolled 1,318 consecutive hypertensive patients without known cardiovascular disease who met the following inclusion criteria: 1) age older than 30 years and 2) the first visit to the participating hospitals was within the last 5 years.ResultsThe mean age was 52 ± 12 years; 62.1% were male, and 41.3% were incident hypertensives. Patients with diabetes mellitus accounted for 7.8% of the population and 43.8% had hyperlipidemia or were on statins at baseline. The mean office blood pressures were 152 ± 20/96 ± 14 mmHg for incident hypertensive patients and 129 ± 13/78 ± 10 mmHg for patients on treatment. Patients with electrocardiographic and echocardiographic left ventricular hypertrophy accounted for 18.9 and 25.6%, respectively. The mean brachial-ankle pulse wave velocity (PWV) was 1564 ± 293 m/s and 19.5% had PWV values of more than 1750 cm/s. Patients with microalbuminuria and chronic kidney disease accounted for 21 and 4%, respectively. The first prescribed class of antihypertensive medications was angiotensin converting enzyme inhibitors in 2.9%, angiotensin receptor blockers (ARBs) in 57.5%, diuretics in 7.6%, calcium channel blockers (CCBs) in 61.0%, beta blockers in 17.3%, and fixed dose combination pill in 27.8%.ConclusionOur interim analysis shows that subclinical target organ damage in hypertension is considerably present for incident or treated hypertensive patients. CCBs and ARBs were the most commonly prescribed classes of antihypertensive medications and fixed dose combination pills were actively used in Korea.Trial registrationNCT01861080. Registered 16 May 2013

Highlights

The Korean Registry of Target Organ Damage in Hypertension aims to evaluate the clinical characteristics and prevalence of subclinical target organ damage in Korean hypertensive patients
Along with controlling blood pressure (BP), identification and treatment of other cardiovascular risk factors, such as hyperlipidemia, smoking, and diabetes mellitus, is crucial in the management of hypertension. Another important factors in the risk stratification and management of hypertensive patients are the existence of subclinical target organ damages (SODs) such as left ventricular hypertrophy (LVH), carotid wall thickening, increased pulsed wave velocity (PWV), chronic kidney disease (CKD) with a reduced estimated glomerular filtration rate, and microalbuminuria (MAU) [3]
As of April 2016, a total of 1,318 patients with primary hypertension had been enrolled in the KorHR registry

Summary

Introduction

The Korean Registry of Target Organ Damage in Hypertension aims to evaluate the clinical characteristics and prevalence of subclinical target organ damage in Korean hypertensive patients. Hypertension is an important worldwide public-health challenge because of its high frequency and concomitant risk of cardiovascular and kidney disease [1]. Along with controlling BP, identification and treatment of other cardiovascular risk factors, such as hyperlipidemia, smoking, and diabetes mellitus, is crucial in the management of hypertension. Another important factors in the risk stratification and management of hypertensive patients are the existence of subclinical target organ damages (SODs) such as left ventricular hypertrophy (LVH), carotid wall thickening, increased pulsed wave velocity (PWV), chronic kidney disease (CKD) with a reduced estimated glomerular filtration rate (eGFR), and microalbuminuria (MAU) [3]. We report the study design and interim analysis of the Korean Registry of Target Organ Damage in Hypertension (KorHR)

Objectives

Methods

Results