Hypertension In Korea Research Articles

TCT-735 Clinical Outcomes of Balloon Pulmonary Angioplasty for Patients With Chronic Thromboembolic Pulmonary Hypertension in Korea

TCT-735 Clinical Outcomes of Balloon Pulmonary Angioplasty for Patients With Chronic Thromboembolic Pulmonary Hypertension in Korea

Temporal trends in adherence to lifestyle recommendations of patients with hypertension in Korea, 2007-2021.

Adherence to lifestyle recommendations is crucial in managing hypertension, independent of medical treatment. This study aimed to evaluate the implementation of adherence to lifestyle recommendations and analyze the trends in adherence to lifestyle recommendations among patients with hypertension in Korea from 2007 to 2021 using the Korea National Health and Nutrition Examination Survey (KNHANES). The study included adults aged ≥20 years. Factors such as regular physical activity, smoking and alcohol abstinence, weight and stress management, and adherence to a healthy diet were analyzed. In 2021, A doublefold increase was observed in the proportion of patients with hypertension who adhered to sodium restriction compared to 2007. However, 70% of patients with hypertension consume more sodium than recommended. Moreover, potassium intake has steadily decreased since 2014, with only 23.8% of patients with hypertension meeting the recommended intake. The body mass index (BMI) and waist circumference of patients with hypertension have gradually increased, with fewer patients maintaining an appropriate weight. The neglect of diet and weight control among young patients with hypertension who experience high stress levels poses challenges in modifying their lifestyles. Patients with hypertension in Korea still consume high amounts of sodium, whereas potassium intake is gradually decreasing. Additionally, obesity rates have been increasing, especially among young patients with hypertension. A multidisciplinary approach is necessary for improving the lifestyle habits of hypertensive patients.

Clinical Characteristics and Visual Prognosis of Idiopathic Intracranial Hypertension in Korea: A Single-center Experience

Purpose: To examine the clinical characteristics, demographic features, and visual prognosis of idiopathic intracranial hypertension (IIH) in Korean patients.Methods: We conducted a retrospective chart review of patients diagnosed with IIH who visited the Neuro-ophthalmology Clinic at Samsung Medical Center from September 2011 to January 2023. This analysis focused on demographic characteristics at onset, clinical manifestations, and visual outcomes at the last follow-up.Results: Out of 34 patients, 20 met the modified Dandy criteria and 14 were presumed to have IIH. The mean age at onset was 32.97 ± 9.6 years with females comprising 85.3% (n = 29) of the sample. The average body mass index (BMI) was 29.15 ± 6.43, with 47.0% of patients (n = 16) classified as obese. The most frequent symptom was headache, reported by 85.3% (n = 29) of patients, followed by pulsatile tinnitus (64.7%, n = 22) and transient visual obscuration (TVO; 32.4%, n = 11). Treatment included observation for 3 patients (8.8%), acetazolamide therapy for 26 patients (76.5%), and ventriculo-peritoneal shunt (V-P shunt) for 2 patients (5.9%). Out of 23 patients with follow-up > 6 months, 87.0%, 8.7%, and 4.3% showed good, fair, and poor visual outcomes, respectively; optic nerve atrophy was observed in 19.6% (9 eyes). The initial peripapillary retinal nerve fiber layer (pRNFL) thickness measured by OCT was 143.56 ± 62.41 μm in the right eye and 139.3 ± 76.38 μm in the left which decreased to 97.39 ± 25.72 and 94.91 ± 19.32 μm, respectively by the last examination.Conclusions: While the proportion of obese patients in this Korean cohort and the average BMI were lower than in western countries, both have increased relative to previous reports from Korea. Most patients experienced a benign course.

Sex differences in cardiovascular risk factors and quality of life among individuals with hypertension in Korea from 2013 to 2018: A cross-sectional cohort study.

As its prevalence increases and its association with cardiovascular disease and mortality is established, there is a need to improve prevention and management strategies for hypertension. Therefore, we aimed to compare differences in cardiovascular health status between men and women with hypertension defined by systolic blood pressure ≥140 mmHg and diastolic blood pressure ≥90 mmHg, and/or treatment with antihypertensive drugs. The association between cardiovascular health status and health-related quality of life was also evaluated. Additionally, a secondary analysis was performed on the cross-sectional data from 7306 adults with hypertension, ≥40 years of age between 2013 and 2018. Of this sample, 51.2% of patients were women from the Korean National Health and Nutrition Examination Survey. The seven Cardiovascular Health Metrics were used to quantify cardiovascular health status and the 5-dimensional European Quality of Life Questionnaire (EQ-5D) was used to evaluate health-related quality of life. A higher proportion of men than that of women was observed in the poor cardiovascular health score group [total score 0-7], with a higher proportion of women in the intermediate group [total score 8-10] and ideal group [total 11-14] (p<0.0001). The proportion of women in the EQ-5D index was higher than that of men in the poor and intermediate groups (p<0.0001), with no difference in the proportion of men and women in the ideal group (p = 0.1452). Furthermore, specific cardiovascular risk factors were different between men and women: women had lower physical activity level and higher prevalence of high cholesterol (≥200 mg/dl), and men had higher body mass indices and worse diet management. These findings indicate that prevention and management strategies for hypertension and cardiovascular health might need to differ for men and women to improve outcomes.

Association between medical complications according to continuity of care and medication adherence in patients with hypertension in Korea: a national population-based cohort study

ObjectivesTo analyse the differences in hypertensive complications according to continuity of care (COC) and medication adherence in patients with hypertension.DesignA national population-based retrospective cohort study.SettingSecondary data analysis using National insurance...

Current Status of Cardiovascular Disease According to the Duration of Hypertension in Korean Adults.

Today, medical technology and healthcare advances have led to an increased life expectancy; however, the prevalence of chronic diseases such as hypertension, diabetes mellitus, stroke, and cardiovascular events is continuously rising. In particular, hypertension is a crucial factor in cardiovascular and cerebrovascular diseases, and it is known that prevention and management are essential. This study investigates the prevalence and management of hypertension in Korean adults and evaluates its correlation with the risk of cardiovascular disease (CVD) and stroke. The Korean National Health and Nutritional Examination Survey (KNHANES) database was utilized for this study (https://knhanes.cdc.go.kr). The subjects of this survey were sampled to represent the entire population of Korea. The study aims to assess the risk of CVD and stroke according to the duration of hypertension. We also examined the impact of hypertension control on the risk of CVD and stroke. This study is a retrospective cross-sectional study, so future risks cannot be assessed, but only the disease status at the same time point. A total of 61,379 subjects were enrolled in the KNHANES database, representing Korea's population of 49,068,178 subjects. The prevalence of hypertension was 25.7% (9,965,618 subjects) of the total population. The prevalence of hypertension increased rapidly with the age of the population. As the duration of hypertension increased, the risks of CVD and stroke also increased. When hypertension lasts longer than 20 years, ischemic heart disease, myocardial infarction, and stroke prevalence were 14.6%, 5.0%, and 12.2%, respectively. However, achieving a target blood pressure (BP) goal below 140/90 mmHg reduced the risk of all CVD and stroke by nearly half. Nevertheless, fewer than two-thirds of patients in Korea with hypertension achieved this targeted blood pressure goal. Our study confirmed that the prevalence of hypertension in Korean adults was higher than a quarter but also showed that the risk of CVD and stroke was significantly reduced by achieving optimal blood pressure control. Based on these results, policy efforts are needed to reach the target BP and improve the treatment rates for hypertension in Korea.

Association of blood pressure and hypertension between parents and offspring: The Korea National Health and Nutrition Examination Survey

As the number of hypertension cases in the pediatric population is growing, we aimed to investigate the parent-offspring association of hypertension in Korea. We performed a cross-sectional analysis using the data of children and adolescents aged 10–18 years and their parents extracted from the Korea National Health and Nutrition Examination Survey (2008–2018). We analyzed the correlation of blood pressure (BP) between offspring and their parents and investigated the odds ratio (OR) of having hypertension in offspring based on parental hypertensive status. A total of 3996 children and adolescents (2224 boys and 1772 girls) aged 10–18 years and their parents (3197 fathers and 3197 mothers) were evaluated. Both boys and girls had positive associations with both parents for systolic and diastolic BP. When neither parent, only the father, only the mother, or both parents were hypertensive, 6.6%, 10.4%, 13.3%, and 25.3% of boys and 6%, 12%, 12.7%, and 22.1% of girls had hypertension, respectively. The risk of having hypertension among offspring was approximately two times higher when one parent was hypertensive and over four times higher when both parents were hypertensive compared to that among controls whose parents were not hypertensive (OR: 2.230, 1.655, and 5.021 in boys with hypertension and 2.321, 2.169, and 4.554 in girls with hypertension in the mother only, the father only, and both parents, respectively). We identified familial aggregation of hypertension in Korea. As there was an increased likelihood of having hypertension in children with parental hypertension, parental hypertension may be utilized as a screening tool for hypertension in children.

Combined influence of sedentary behaviours and chronic pain on depressive symptoms in older Korean adults with hypertension.

Depressive symptoms in hypertensive patients are linked to poor adherence to treatment. Sedentary behaviours and chronic pain can increase blood pressure and depressive symptoms, respectively. However, the impact of their coexistence on depressive symptoms in older adults with hypertension has not yet been investigated. This study aimed to identify the combined influence of sedentary behaviours and chronic pain on depressive symptoms in older adults with hypertension in Korea. This cross-sectional study used data from the sixth Korea National Health and Nutrition Examination Survey from January to December 2014. The survey adopted multistage stratified sampling by geographical region, gender, and age. For the data analysis, a total of 573 patients with hypertension aged 65 years or older were included. Approximately, 61.0% of depressed older patients had both sedentary behaviours and chronic pain compared with patients without depressive symptoms. In multivariate logistic regression analysis, compared with patients without either sedentary behaviours or chronic pain, older adults with hypertension who presented both sedentary behaviours, and chronic pain had the highest risk of depressive symptoms (odds ratio = 13.86, 95% confidence interval = 5.87-32.71; P < 0.001). Coexistence of sedentary behaviours and chronic pain in older hypertensive patients may lead to depressive symptoms. Evaluating both sedentary behaviours and chronic pain when assessing depressive symptoms in patients with hypertension would be beneficial in planning a patient-centred approach for controlling blood pressure. More prospective cohort studies with larger samples are required to identify the causal relationships.

The Effect of Chronic Disease Management Program on the Risk of Complications in Patients With Hypertension in Korea.

BackgroundA chronic disease management program was implemented in April 2012 to lower out-of-pocket costs for repeat visits to the same clinic. The aim of this study was to investigate the association between participating in this program and the onset of complications among patients with hypertension using whole-nation claims data.MethodsWe used National Health Insurance Service data (2011–2018) and patients with newly detected hypertension from 2012 to 2014 were selected. Chronic disease management program reduces the out-of-pocket expenses of consultation fee from 30% to 20% when patients enroll in this program by agreeing to visit the same clinic for the treatment of hypertension or diabetes. As the dependent variable, acute myocardial infarction (MI), stroke, chronic kidney disease (CKD), and heart failure (HF) were selected. For analysis, cox proportional hazards model was used.ResultsTotal participants were 827,577, among which 102,831(12.6%) subjects participated in the chronic disease management. Participants of the chronic disease management program were more likely to show lower hazard ratios (HRs) than those of non-participants in terms of all complications (MI: HR, 0.75; 95% confidence interval [CI], 0.68–0.82; stroke: HR, 0.75; 95% CI, 0.72–0.78; CKD: HR, 0.90; 95% CI, 0.85–0.96; HF: HR, 0.56; 95% CI, 0.52–0.61).ConclusionThe results showed that participants of the chronic disease management program were less likely to have hypertension complications compared to non-participants. Enhancing the participation rate may be related to better outcomes and reducing medical expenses among patients with chronic diseases.

A Retrospective Population-Based Survival Study of Idiopathic Pulmonary Arterial Hypertension in Korea

BackgroundFew studies used nationwide data to assess the survival rates (SRs) and death risk for idiopathic pulmonary arterial hypertension (IPAH; ICD-10 I27.0) in Korea.MethodsIPAH data (N = 9,017; female:male = 6:4) were collected from the National Health Insurance Service in Korea, from 2006 through 2017. The data consisted of primary diagnoses related to IPAH. The Kaplan–Meier method and Cox proportional-hazards analyses were carried out.ResultsThe mean age was 62.3 (± 19.4) years, 64.2 (± 18.9) years in female and 59.4 (± 19.8) years in male (P < 0.001). The one-, three-, five- and 10-year SRs for IPAH were 89.0%, 79.8%, 72.3% and 57.0%, respectively. The adjusted hazard ratio (HR) of IPAH was 1.81 (95% confidence interval [CI], 1.26–2.59) in 60–69 age group, 3.42 (95% CI, 2.40–4.87) in 70–79, and 7.73 (95% CI, 5.43–11.0) in 80s. Other risk factors were male, low-income status, diabetes, myocardial infarction, atrial fibrillation, ischemic stroke, hemorrhagic stroke, and malignant neoplasm.ConclusionThe 10-year SR of IPAH was 57% in Korea. The HR for IPAH was significantly high in patients with older age and other risk factors.

Association between self-reported physical activity and indicators of cardiovascular risk in community-dwelling older adults with hypertension in Korea: A cohort study.

The prevalence of hypertension has increased with the rise in the elderly population, and high blood pressure is a major cause of cardiovascular disease. Physical activity is an important strategy for preventing cardiovascular disease. The study aimed to explore the association between physical activity and cardiovascular risk indicators in community-dwelling older adults with hypertension.This study is a secondary data analysis of a prospective longitudinal study using data from the Elderly Cohort Database of the National Health Insurance Service in South Korea between 2002 and 2013. Participants included 10,588 older adults (≥60 years) with hypertension. Data assessing self-reported physical activity and directly measured blood pressure, fasting blood glucose, body mass index, and total cholesterol levels throughout the 12-year study were extracted from the original database and analyzed. Participants were categorized into 4 groups based on the reported changes in physical activity over time: Group I (Maintaining No Physical Activity Group), II (Changing from No Physical Activity to Physical Activity Group), III (Changing from Physical Activity to No Physical Activity Group), and IV (Maintaining Physical Activity Group). Cox proportional hazard model was used to confirm the risk of cardiovascular indicators over time in each group.Participants’ mean age was 64.2 years in the initial year of 2002. The number of participants in Groups I, II, III, and IV was 4032, 2697, 1919, and 1940, respectively. Group IV showed a significant decline in risk for uncontrolled hypertension compared to Group I (hazard ratio = 0.87, 95% confidence interval [0.800–0.948]). Group II showed a significant decrease in risk for uncontrolled diabetes compared to Group I (hazard ratio = 0.94, 95% confidence interval [0.888–0.999]).The findings indicated that physical activity is a significant factor associated with indicators of cardiovascular risk in older people with high blood pressure. Healthcare providers should be aware of the importance of older adults’ physical activity and encourage them to perform and maintain it steadily for better long-term cardio-metabolic outcomes.

A cost-effectiveness analysis of the Chronic Disease Management Program in patients with hypertension in Korea.

The Chronic Disease Management Program (CDMP) of Korea has been introduced to improve care continuity in patients with hypertension and diabetes. This study evaluated the cost effectiveness of the CDMP in patients with hypertension from the perspective of the healthcare payer. A cost-effectiveness analysis was performed based on a Markov simulation model. The cost and effect of the CDMP versus usual care was compared in individuals aged 40 years or above. The two strategies were presumed to result in a difference in the incidence of myocardial infarction, stroke, and chronic kidney disease. The model was analyzed over the lifetime of the cohort. Incremental cost-effectiveness ratio (ICER) was calculated by dividing the difference in lifetime costs by the difference in lifetime effects (quality adjusted life years, QALYs) between the two strategies. Costs were expressed in Korean Won (KRW). The ICER value of the CDMP participation strategy was -5 761 088 KRW/QALY compared to usual care. Similar tendencies were found when limiting the population to only clinic users (-3 843 355 KRW/QALY) and national health examination participants (-5 595 185 KRW/QALY). The CDMP was highly cost-effective in patients with hypertension aged 40 years or above. Implementing efficient policies that enhance care coordination and improve outcomes in patients with hypertension is important.

Real-time prediction of upcoming respiratory events via machine learning using snoring sound signal.

The aim of the study was to inspect the acoustic properties and sleep characteristics of a preapneic snoring sound. The feasibility of forecasting upcoming respiratory events by snoring sound was also investigated. Participants with habitual snoring or a heavy breathing sound during sleep were recruited consecutively. Polysomnography was conducted, and snoring-related breathing sound was recorded simultaneously. Acoustic features and sleep features were extracted from 30-second samples, and a machine learning algorithm was used to establish 2 prediction models. A total of 74 eligible participants were included. Model 1, tested by 5-fold cross-validation, achieved an accuracy of 0.92 and an area under the curve of 0.94 for respiratory event prediction. Model 2, with acoustic features and sleep information tested by Leave-One-Out cross-validation, had an accuracy of 0.78 and an area under the curve of 0.80. Sleep position was found to be the most important among all sleep features contributing to the performance of the 2 models. Preapneic sound presented unique acoustic characteristics, and snoring-related breathing sound could be deployed as a real-time apneic event predictor. The models, combined with sleep information, serve as a promising tool for an early warning system to forecast apneic events. Wang B, Yi X, Gao J, etal. Real-time prediction of upcoming respiratory events via machine learning using snoring sound signal. J Clin Sleep Med. 2021;17(9):1777-1784.

Renin-angiotensin system modulators and other risk factors in COVID-19 patients with hypertension: a Korean perspective

BackgroundWhile hypertension is the most common comorbid condition in patients with coronavirus disease 2019 (COVID-19) in Korea, there is a lack of studies investigating risk factors in COVID-19 patients with hypertension in Korea. In this study, we aimed to examine the effects risk factors in hypertensive Korean COVID-19 patients.MethodsWe selected patients from the database of the project #OpenData4Covid19. This information was linked to their 3-year historical healthcare data. The severity of the disease was classified into five levels. We also clustered the levels into two grades.ResultsThe risk factors associated with COVID-19 severity were old age, diabetes mellitus, cerebrovascular disease, chronic obstructive pulmonary disease (COPD), malignancy, and renal replacement therapy. The use of angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) both before and after a diagnosis of COVID-19 were not associated with COVID-19 severity. A multivariate analysis revealed that old age, male sex, diabetes mellitus, and renal replacement therapy were risk factors for severe COVID-19.ConclusionThe results suggest that in hypertensive patients with COVID-19, older age, male sex, a diagnosis of diabetes mellitus, and renal replacement therapy were risk factors for a severe clinical course. In addition, the use of ARBs and ACEIs before or after COVID-19 infection did not affect a patient’s risk of contracting COVID-19 nor did it contribute to a worse prognosis for the disease. These results highlighted that precautions should be considered for hypertensive patients with those risk factors and do not support discontinuation of ARBs and ACEIs during COVID-19 pandemic.

Clinical outcomes of COVID-19 following the use of angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers among patients with hypertension in Korea: a nationwide study.

OBJECTIVESRecent evidence has shown no harm associated with the use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) in patients with coronavirus disease 2019 (COVID-19). We sought to further clarify the possible association between ACEI/ARB use and the risk of poor clinical outcomes of COVID-19.METHODSFrom the completely enumerated COVID-19 cohort in Korea, we identified 1,290 patients with hypertension, of whom 682 had and 603 did not have records of ACEI/ARB use during the 30-day period before their COVID-19 diagnosis. Our primary endpoint comprised clinical outcomes, including all-cause mortality, use of mechanical ventilation, intensive care unit admission, and sepsis. We used inverse probability of treatment weighting (IPTW) to mitigate selection bias, and a Poisson regression model to estimate the relative risks (RRs) and 95% confidence intervals (CIs) for comparing outcomes between ACEI/ARB users and non-users.RESULTSCompared to non-use, ACEI/ARB use was associated with lower clinical outcomes (IPTW-adjusted RR, 0.60; 95% CI, 0.42 to 0.85; p=0.005). For individual outcomes, ACEI/ARB use was not associated with all-cause mortality (IPTW-adjusted RR, 0.62; 95% CI, 0.35 to 1.09; p=0.097) or respiratory events (IPTW-adjusted RR, 0.99; 95% CI, 0.84 to 1.17; p=0.904). Subgroup analysis showed a trend toward a protective role of ACEIs and ARBs against overall outcomes in men (IPTW-adjusted RR, 0.84; 95% CI, 0.69 to 1.03; pinteraction=0.008) and patients with pre-existing respiratory disease (IPTW-adjusted RR, 0.74; 95% CI, 0.60 to 0.92; pinteraction=0.002).CONCLUSIONSWe present clinical evidence to support continuing ACE/ARB use in COVID-19 patients with hypertension based on the completely enumerated Korean cohort.

제2형 당뇨 동물모델을 이용한 방풍통성산의 고혈당 개선효과

Background: Type II diabetes is considered as one of the common diseases. Bangpungtongseongsan (BPS) has been used as a traditional medicine for treating obesity and hypertension in Korea. According to previous reports, it has anti-obesity, anti-chronic asthma, anti-oxidant, and anti-inflammatory properties. However, the effects of BPS on type II diabetes have not yet been elucidated. Thus, in this sutudy, we evaluated the water extracts of BPS using type II diabetes animal models.<BR>Methods and Results: Each group was orally administered with BPS (170, 850 and 1,700 ㎎/㎏) for approximately 13 weeks. A mixture of 150 ㎎/㎏ metformin and 10 ㎎/㎏ sitagliptin (MS) was used as a positive control. The glycated hemoglobin (HbA1c) and glucose levels, and hematological parameters including blood urine nitrogen, creatinine, low density lipoprotein and total cholesterol, were measured using blood samples. Treatment with 170 ㎎/㎏ BPS decreased the HbA1c and glucose levels in blood without affecting the weights of the animals. However, threatment with 1,700 ㎎/㎏ BPS reduced the weights and fatty liver, and increased the blood glucose level in type II diabetes animal models <BR>Conclusions: These results indicate that a low dose of BPS for 13 weeks, which reduces HbA1c and blood glucose levels, could be used for the treatment of type II diabetes. However, further studies are required to elucidate how active ingredients of BPS influence HbA1c and glucose levels in blood.

Relationship between intraocular pressure and parameters of obesity in ocular hypertension.

To evaluate the correlation between intraocular pressure (IOP) and various obesity-related health factors in patients with ocular hypertension in Korea. A total of 40 850 subjects underwent age, sex, body weight, and height assessments and automated multiphasic tests, including non-contact tonometry, automated perimetry, fundus photography, systolic/diastolic blood pressure measurement, and evaluation of obesity-related health parameters such as obesity index, body mass index (BMI), a body shape index (ABSI), and waist-to-height ratio (WtHR). Subjects were divided into ocular hypertension group and normal IOP group according to IOP after matching of age and sex. Of 40 850 participants, 1515 (3.7%) had ocular hypertension, and 1515 with normal IOP were selected as controls using propensity score matching. The mean IOP of control group was 15.3±2.3 mm Hg, compared with 23.3±1.6 mm Hg in ocular hypertension group. Height, obesity index, BMI, and WtHR in the ocular hypertension group were significantly higher than in the normal IOP group (P<0.001, P<0.001, P=0.009, P=0.002). IOP of ocular hypertension was positively correlated with obesity index (P=0.027) and BMI (P=0.016), whereas IOP of control was positively correlated with blood pressure (P<0.001, P=0.002), obesity index (P<0.001), BMI (P<0.001), and WHtR (P=0.002). Systolic blood pressure (β=0.022, P<0.001) and body weight (β=0.016, P=0.02) were precursors of IOP in normal subjects, but sex (male; β=-0.231, P=0.008) and obesity index (β=-0.007, P=0.017) were precursors of ocular hypertension according to multiple regression analysis. Among various obesity-related health parameters, obesity index is the best indicator for further increase in IOP in ocular hypertension group.

A Nationwide multicenter registry and biobank program for deep phenotyping of idiopathic and hereditary pulmonary arterial hypertension in Korea: the PAH platform for deep phenotyping in Korean subjects (PHOENIKS) cohort

BackgroundPulmonary arterial hypertension (PAH) is a progressive, chronic disease without curative treatment. Large registry data of these patient populations have been published, although, phenotypic variants within each subtype of PAH have not been elucidated. As interest towards personalized medicine grows, the need for a PAH cohort with a comprehensive understanding of patient phenotypes through multiomics approaches, called deep phenotyping, is on the rise. The PAH Platform for Deep Phenotyping in Korean Subjects (PHOENIKS) cohort is designed to collect clinical data as well as biological specimens for deep phenotyping in patients with idiopathic PAH (IPAH) and heritable PAH (HPAH) in Korea.MethodsA total of 17 regional hospitals are currently working on enrolling up to 100 consecutive IPAH/HPAH patients for obtaining clinical data and biological specimens across Korea. The diagnosis of PAH is based on right heart catheterization. All clinical data is stored in a government-based online database. Each participating hospitals collect a whole blood sample from each patient, through which DNA, RNA, serum, plasma, and peripheral blood mononuclear cells will be extracted from the buffy coat layer for further multiomics analysis.ResultsNot applicable.ConclusionsThe PHOENIKS cohort is enrolling IPAH and HPAH patients across Korea to determine the prognosis and drug response in different phenotypic variant. The data generated by this cohort are expected to open new doors for personalized medicine in PAH patients of South Korea.Trial registrationClinicalTrials.gov NCT03933579. Registered on May 1st, 2019.

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

The purpose of the present study was to describe the temporal trends in prevalence and management status of hypertension in Korea between 1998 and 2015. Data of adults who were aged 30 years or older were extracted from the Korea National Health and Nutrition Examination Survey, a nationwide representative population-based survey. Hypertension was prevalent in 30.5% of Korean adults. The age and sex standardized prevalence showed little change between 1998 and 2015. The elderly population and men showed higher prevalence. The rates of awareness, treatment, and control showed substantial improvements among hypertensive subjects between 1998 and the time period of 2007‒2009 (awareness, from 23.5 to 66.3%; treatment, from 20.4 to 60.3%; and control, from 4.9 to 42.1%), after which the numbers reached a plateau and no significant changes were observed subsequently (67.3%, 63.6%, and 46.2%, respectively, between 2013 and 2015). The management status remained poor especially among the young population and in men. In conclusion, the hypertension prevalence remained stable at approximately 30% in Korea between 1998 and 2015. While awareness, treatment, and control of hypertension improved remarkably, the young population and particularly men showed a suboptimal management status.

Current status of pulmonary arterial hypertension in Korea.

Pulmonary arterial hypertension (PAH) is characterized by remodeling of the distal pulmonary arteries resulting in high pulmonary vascular resistance and, eventually, right ventricular heart failure. Although current advances in PAH therapy have improved outcomes, poor survival remains a reality worldwide, including Korea. One of the most important issues in PAH is the late diagnosis, since screening or diagnostic efforts are often overlooked due to the rarity of disease. Data from Korean registries and observational cohorts show that delayed detection leads to increased morbidity. Additionally, low percentages of Korean patients are committed to intensive PAH-targeted therapy. Current Korean health insurance policies’ lack of coverage for new PAH-targeted drugs and upfront combination therapy may also hamper the improvement of treatment outcomes. Understanding individual variability in response to therapeutics through deep phenotyping is a novel strategy that should be considered when treating PAH. Overall, early detection of PAH by proactive screening together with early, intensive, individualized PAH therapy using deep phenotyping is crucial for improving prognoses for PAH patients in Korea.