Hypertension In Korea Research Articles

A Community-Based Intervention for Improving Medication Adherence for Elderly Patients with Hypertension in Korea.

The chronic disease management program, a community-based intervention including patient education, recall and remind service, and reduction of out-of-pocket payment, was implemented in 2005 in Korea to improve patients’ adherence for antihypertensive medications. This study aimed to assess the effect of a community-based hypertension intervention intended to enhance patient adherence to prescribed medications. This study applied a non-equivalent control group design using the Korean National Health Insurance Big Data. Hongcheon County has been continuously implementing the intervention program since 2012. This study involved a cohort of patients with hypertension aged >65 and <85 years, among residents who lived in the study area for five years (between 2010 and 2014). The final number of subjects was 2685 in both the intervention and control region. The indirect indicators were analyzed as patients’ adherence and level of continuous treatment using the difference-in-difference regression. The proportion of hypertensive patients who continuously received insurance benefits for >240 days in 2014 was 81.0% in the intervention region and 79.7% in the control region. The number of dispensations per prescription and the dispensation days per hypertensive patient in the intervention region increased by approximately 10.88% and 2.2 days on average by month, respectively, compared to those in the control region. The intervention program encouraged elderly patients with hypertension to receive continuous care. Another research is needed to determine whether further improvement in the continuity of comprehensive care will prevent the progression of cardiovascular diseases.

Demographics, treatment trends, and survival rate in incident pulmonary artery hypertension in Korea: A nationwide study based on the health insurance review and assessment service database.

Epidemiologic data regarding pulmonary arterial hypertension (PAH) have relied on registries from Western countries. We assessed the current status of PAH in the Korean population. The Health Insurance Review and Assessment Service (HIRA) claim database, which comprises nationwide medical insurance data of Koreans from 2008–2016, was assessed to determine the current status of PAH. Overall, 1,307 patients were newly diagnosed with PAH from 2008–2016 (0.0005%, annual incidence: 4.84 patients/1 million people/year). The mean age at diagnosis was 44±13 years (range 18–65) and patients were mostly women (n = 906, 69.3%). Cases of idiopathic PAH (51.6%) accounted for the largest proportion, followed by acquired PAH (APAH) associated with congenital heart disease (25.8%) and APAH with connective tissue disease (17.2%). Overall, 807 (61.7%) patients received a single PAH-specific treatment based on their last prescription, of which bosentan (50.6%) was the most frequently used. Only 240 (18.4%) patients received combination therapy, with the bosentan-beraprost combination (32.9%) being the most common. During the mean follow-up of 1.9 years, the 1-, 2-, 3-, and 5-year estimated survival rates were 85%, 62%, 54%, and 46%, respectively. The prevalence and incidence of PAH in the Korean population is currently comparable with that in previous registries. The 5-year survival rate was slightly higher in the Korean population than previously reported.

A13448 Prevalence, Awareness, Treatment, and Control of Hypertension in Korea

A13448 Prevalence, Awareness, Treatment, and Control of Hypertension in Korea

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)

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

Simultaneous Quantification of Eight Marker Compounds in Yongdamsagan-Tang Using a High-Performance Liquid Chromatography Equipped with Photodiode Array Detector.

Yongdamsagan-tang (YDSGT) has been used clinically for the treatment of acute- and chronic-urethritis, cystitis, orchitis and hypertension in Korea. In this study, a powerful method based on high-performance liquid chromatography (HPLC) with photodiode array (PDA) detection was established and validated for the quantitative analysis of eight components: chlorogenic acid, gentiopicroside, liquiritin apioside, liquiritin, nodakenin, baicalin, wogonoside and glycyrrhizin in YDSGT extract. The compounds were separated with a Gemini C18 analytical column (column temperature: 40°C; mobile phase: 0.1% (v/v) aqueous trifluoroacetic acid (A) and acetonitrile (B); flow rate: 1.0 mL/min; injection volume: 10 μL). The PDA detector scanned the range 190-800 nm and the marker compounds were monitored at 254, 275, 325 and 335 nm. The correlation coefficients of all compounds were 1.000 and the results showed excellent linearity. The lower limits of detection and quantification of the analytes were 0.01-0.09 μg/mL and 0.03-0.28 μg/mL, respectively. The extraction recoveries of the marker compounds were 98.13-103.86%, with relative standard deviation values not exceeding 2.10%. The precision of intra- and inter-day measurements were 0.09-1.78% and 0.12-2.09%, respectively. The content of the eight marker compounds in the freeze-dried YDSGT extract were 1.41-23.71 mg/g.

Psychometric Properties of the Hypertension Self-Care Behavior Scale for Elders with Hypertension in Korea

Psychometric Properties of the Hypertension Self-Care Behavior Scale for Elders with Hypertension in Korea

Humulus japonicus Prevents Dopaminergic Neuron Death in 6-Hydroxydopamine-Induced Models of Parkinson's Disease.

Humulus japonicus (HJ), popularly known as Japanese hops, is a traditional herbal medicine widely used for the treatment of pulmonary disease, skin disease, and hypertension in Korea. HJ exerts scavenging effects against reactive oxygen species (ROS), such as superoxide radical, hydroxyl radical, and hydrogen peroxide. Moreover, dysfunction and damage of mitochondria elicited by ROS are of critical importance in the pathogenesis of Parkinson's disease (PD). The present study aimed to examine neuroprotective potential of extracts of HJ using in vitro and in vivo 6-hydroxydopamine (6-OHDA) models. SH-SY5Y cells were cultured to explore the mechanisms for the neuroprotective effect of HJ in vitro. Unilateral 6-OHDA-induced mouse model of PD was established to investigate the neuroprotective effect of HJ on dopaminergic neurons in substantia nigra pars compacta (SNc) and striatum in vivo. Methanol extract of HJ (HJM) significantly attenuated cytotoxicity and the mitochondrial apoptosis pathway caused by 6-OHDA in SH-SY5Y cells. In addition, HJM significantly increased glutathione levels and decreased phosphorylation of ERK1/2 in SH-SY5Y cells exposed to 6-OHDA. In the in vivo study, the administration of methanol or ethanol extract of HJ improved the motor dysfunction and notably reduced dopaminergic cell death and fiber loss in the SNc and striatum caused by 6-OHDA. Our findings demonstrate that HJ may have therapeutic potential to protect dopaminergic neuron degeneration in Parkinson's disease.

Humulus japonicus inhibits the progression of Alzheimer's disease in a APP/PS1 transgenic mouse model.

Humulus japonicus Siebold & Zucc. (HJ) has traditionally been administered to patients with pulmonary disease, skin disease and hypertension in Korea, and it is considered to exert anti-inflammatory, antioxidant, antimicrobial and anti-mycobacterial effects. However, its effects against Alzheimer's disease (AD) have yet to be explored. Thus, this study was carried out to investigate whether HJ has a beneficial effect on the progression of AD in an animal model. A methanolic extract of HJ (500 mg/kg/day) was intragastrically administered to 5-month-old APP/PS1 transgenic (Tg-APP/PS1) mice for 2.5 months. Novel object recognition and Y-maze alteration tests were used to assess cognitive function, and an immunohistochemical assay was performed to assess amyloid β (Aβ) deposition, tau phosphorylation and gliosis. An in vitro assay using a microglial cell line was also performed to investigate the anti-inflammatory effects of HJ. Our results revealed that HJ significantly decreased the mRNA and protein expression levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6 and inducible nitric oxide synthase (iNOS) induced by lipopolysaccharide in the microglial cell line. The administration of HJ for 2 months improved the cognitive function of Tg-APP/PS1 mice. HJ notably reduced the area occupied by Aβ and neurofibrillary tangles, and the number of activated astrocytes and microglia in the cortex of Tg-APP/PS1 mice. The findings of our study suggest that HJ has the therapeutic potential to inhibit the progression of AD and to improve cognitive deterioration in Tg-APP/PS1 mice.

PS 11-11 ASSOCIATION BETWEEN SOCIOECONOMIC PARAMETERS AND HYPERTENSION IN KOREA

Objective: We investigated the relationship of socioeconomic status (SES) with the prevalence and the incidence of hypertension in Korea, which is experiencing dynamic socioeconomic transition. Design and Method: We analyzed population from prospective cohort study, the Korean Genome and epidemiology study which enrolled subjects from 2001 to 2003 in Ansan and Ansung. We recruited 7,089 subjects who underwent 4-year follow-up until 2007. Education duration and income level, two major components of SES, were stratified as follows: Short (≤ 6 years), Mid-Short (7–9 years), Mid-Long (10–12 years), and Long (≥ 12 years) for education; Low (≤ \500,000), Mid-Low (\500,000-\1499999), Mid-High (\1,500,000-\2,999,999) and High (≥ \3,000,000) for monthly income. Results: In overall, 2,805 subjects (39.5%) were diagnosed as hypertension at baseline. Education and income showed inverse relationship with hypertension prevalence and incidence (p < 0.001,). Men with higher SES showed higher obesity level (p < 0.001), while women demonstrated inverse association (p < 0.001). In multivariate analysis, shorter duration of education was significantly associated with prevalent hypertension, but income level was not. After 4-year follow-up, 605 subjects (14.2%) were newly diagnosed as hypertension. The hazard ratios (95% confidence interval) for incident hypertension across longer education were 0.739 (0.537–1.018), 0.634 (0.458–0.877), and 0.582 (0.387–0.877), compared with Short (reference). There was no significant relationship across higher income: 0.969 (0.701–1.340), 0.770 (0.537–1.103), and 0.682 (0.448–1.036) compared with Low (reference), either. Conclusions: Education and income level both had associated with hypertension prevalence and incidence, however, only education was independent prognosticators when other risk factors were adjusted.

Epidemiology of chronic thromboembolic pulmonary hypertension in Korea: results from the Korean registry.

Background/Aims:The diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH) is difficult for numerous reasons and is related with a poor prognosis. In Korea, the incidence of CTEPH and its clinical features are unknown. Thus, in this study, we evaluated the clinical characteristics and outcomes of CTEPH in a Korean cohort.Methods:This study included South Korean patients diagnosed with CTEPH between September 2008 and October 2011. Baseline characteristics, treatments and outcomes were analyzed.Results:A total of 134 patients were included in this study with 76 females (56.7%). Their median age was 58.3 ± 15.9 years and dyspnea (112 patients, 83.5%) was the most common presenting symptom. Sixty-three patients (47%) had a history of acute pulmonary embolism or deep vein thrombosis, and six (4.5%) had pulmonary tuberculosis. In total, 28 patients (21%) underwent pulmonary thromboendarterectomy (PTE), and 99 patients had medical therapy. During the study period, 18 patients (13.4%) died. In a multivariate analysis, higher hemoglobin (relative risk [RR], 1.516; 95% confidence interval [CI], 1.053 to 2.184; p = 0.025) and lower total cholesterol levels (RR, 0.982; 95% CI, 0.965 to 0.999; p = 0.037) were associated with increased mortality.Conclusions:This was the first national cohort study of Korean patients with CTEPH. Accurate diagnosis, characterization and distributions of CTEPH are imperative for prompt treatment in patients, particularly those undergoing PTE.

Disparities in socioeconomic status and neighborhood characteristics affect all-cause mortality in patients with newly diagnosed hypertension in Korea: a nationwide cohort study, 2002-2013.

BackgroundPrevious studies have shown that contextual factors and individual socioeconomic status (SES) were associated with mortality in Western developed countries. In Korea, there are few empirical studies that have evaluated the association between SES and health outcomes.MethodsWe conducted cohort study to investigate the socioeconomic disparity in all-cause mortality for patients newly diagnosed with hypertension in the setting of universal health care coverage. We used stratified random sample of Korean National Health Insurance enrollees (2002–2013). We included patients newly diagnosed with hypertension (n = 28,306) from 2003–2006, who received oral medication to control their hypertension. We generated a frailty model using Cox’s proportional hazard regression to assess risk factors for mortality.ResultsA total of 7,825 (27.6%) of the 28,306 eligible subjects died during the study period. Compared to high income patients from advantaged neighborhoods, the adjusted hazard ratio (HR) for high income patients from disadvantaged neighborhoods was 1.10 (95% CI, 1.00–1.20; p-value = 0.05). The adjusted HR for middle income patients who lived in advantaged versus disadvantaged neighborhoods was 1.17 (95% CI, 1.08–1.26) and 1.27 (95% CI, 1.17–1.38), respectively. For low income patients, the adjusted HR for patients who lived in disadvantaged neighborhoods was higher than those who lived in advantaged neighborhoods (HR, 1.35; 95% CI, 1.22–1.49 vs HR, 1.28; 95% CI, 1.16–1.41).ConclusionsNeighborhood deprivation can exacerbate the influence of individual SES on all-cause mortality among patients with newly diagnosed hypertension.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-015-0288-2) contains supplementary material, which is available to authorized users.

The Association between Parameters of Socioeconomic Status and Hypertension in Korea: the Korean Genome and Epidemiology Study.

We investigated the association between socioeconomic status and hypertension in Korea, a country that has experienced a dynamic socioeconomic transition. We analyzed participants of a prospective cohort study—the Korean Genome and Epidemiology Study—enrolled between 2001 and 2003. We recruited 7,089 subjects who underwent a 4-year follow up till 2007. Education and income levels, which are important parameters for socioeconomic status, were stratified into 4 groups. Education level was defined as short (≤ 6 years), mid-short (7–9 years), mid-long (10–12 years), and long (≥ 12 years). Monthly income level was stratified as low (< 500,000 KRW), mid-low (500,000–1,499,999 KRW), mid-high (1,500,000–2,999,999 KRW) or high (≥ 3,000,000 KRW). At baseline, 2,805 subjects (39.5%) were diagnosed with hypertension. Education and income levels were inversely associated with the prevalence and incidence of hypertension (P < 0.001). In multivariate analysis, a shorter duration of education was significantly associated with a higher prevalence of hypertension (P < 0.001), but income level was not (P = 0.305). During the follow-up, 605 subjects (14.2%) were newly diagnosed with hypertension. In multivariate adjusted analysis, the hazard ratios (95% confidence interval) for incident hypertension across the longer education groups were 0.749 (0.544–1.032), 0.639 (0.462–0.884), and 0.583 (0.387–0.879), compared with the shortest education group. There was no significant association between incident hypertension and income across higher income groups: 0.988 (0.714–1.366), 0.780 (0.542–1.121), and 0.693 (0.454–1.056), compared with the lowest income group. In conclusion, education and income levels are associated with the prevalence and incidence of hypertension, but only education is an independent prognostic factor in Korea.

The Predictive Modeling of Middle-aged Hypertension using Integrated Method of Decision Tree and Neural Network

The purpose of present study was to analyze the factors that affects the middle-aged hypertension in Korea. Data were from the A Study on the Seoul Welfare Panel Study 2010. Subjects were 2,564 persons (1,177 male; 1,387 female) aged 40-59 in South Korea. Dependent variable was defined as prevalence ratio of hypertension. Explanatory variables were included as gender level of education, household income, smoking, drinking, self-reported health status, and physical activity. A prediction model was developed by the use of a Decision Tree and Neural Network Algorithm. In the Prediction model, self reported health status, physical activity, education, smoking, household income were significantly associated with middle-aged hypertension in Korea. Received (February 04, 2015), Review request (February 05, 2015), Review Result (February 25, 2015) Accepted (March 18, 2015), Published (April 30, 2015) 506-706 Dept. Speech Language Pathology & Audiology, Nambu University, Chumdan 23, Gwansangu, Gwangju, Korea email: byeon@nambu.ac.kr (Corresponding Author) 506-706 Dept. Physical Therapy, Nambu University, Chumdan 23, Gwansangu, Gwangju, Korea email: geriatricpt1@naver.com The Predictive Modeling of Middle-aged Hypertension using Integrated Method of Decision Tree and Neural Network Copyright c 2015 HSST 10

Economic Evaluation of Catheter-Based Renal Denervation for Patients with Resistant Hypertension in Korea.

Economic Evaluation of Catheter-Based Renal Denervation for Patients with Resistant Hypertension in Korea.

고혈압 관리에 영향을 미치는 요인 분석: 제4기 국민건강영양조사자료를 중심으로

Abstract The purpose of this study was to identify the factors related to awareness, treatment, and control of hypertension in Korea using data from the 4th KNHANES. The analytical technique employed multivariate logistic regression analysis and the major findings of this research are as follows. First, awareness of hypertension was positively associated with age, occupation, self-rated health, Body Mass Index, and health examination since 2 years ago, in both males and females. Second, treatment of hypertension was positively associated with age, self-rated health, Body Mass Index, and health examination since 2 years ago, in both males and females. Third, control of hypertension was positively associated with age, self-rated health, Body Mass Index, and health examination since 2 years ago, in both males and females. Finally, the results of analysis suggest that the government should especially focus on the vulnerable group and continue to strengthen effective efforts for improving awareness, treatment, and control of hypertension.

A Trend Analysis of the Prevalence, Awareness, Treatment, and Control of Hypertension by Age Group

ObjectivesWe examined the trends in prevalence, awareness, treatment, and control of hypertension in Korea as a basis for improving hypertension control programs.Methods12 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.ResultsThe 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.ConclusionsThe prevalence of hypertension was increasing and the hypertension awareness, treatment, and control rates were low in younger age groups and males.

Prevalence, Awareness, Treatment and Control of Hypertension in Korea

Prevalence, Awareness, Treatment and Control of Hypertension in Korea

Does hypertension begin in adolescence?

Does hypertension begin in adolescence?

한국노인의 고혈압 유병률과 위험요인

Purpose: The purpose of this study was to identify the prevalence of hypertension and its risk factors among community dwelling aged 65 and over in South Korea. Methods: A total of 1,367 subjects from the 2010 Korean National Health and Nutrition Examination Survey (KNHANES) were selected. The data analysis was conducted by SPSS WIN 19.0 using descriptive statistics, <TEX>${\chi}^2$</TEX>-test, and logistic regression analysis. Results: The prevalence of hypertension was found to be 47.70%. Logistic regression analysis shows that hypertension was more prevalent as people became older; in females; in elderly who were not employed as compared to those employed; elderly with diabetes, and obesity as compared to those without these health conditions; as elderly who performed more moderate intensity exercise. While, education, household income, high risk alcoholic drinking, smoking, stress perception, usual activity, and eating out behavior were not associated with prevalence of hypertension in this study. Conclusion: The finding of prevalence of hypertension and its risk factors is expected to promote the screening or prevention strategy for community dwelling aged 65 and over at risk of hypertension in Korea.

A Case of Hereditable Pulmonary Hypertension

Pulmonary arterial hypertension is a rare life-threatening disorder. Inherited cases of this disorder are known as heritable pulmonary arterial hypertension. Familial cases of heritable pulmonary arterial hypertension are caused by germline mutations of the bone morphogenetic protein receptor type 2 gene (BMPR), a type II receptor of the TGF-beta superfamily. This has not been reported in Korea. We report the first case of familial hereditable pulmonary arterial hypertension in Korea. The family has a mutation in exon12 of the BMPR2 gene (c.2695C > T, p.R899X). (Korean J Med 2012;83:494-497)