Hypertension In Korean Adults Research Articles

Association between Away-from-Home Meals and Hypertension in Korean adults: Analyzing Data from the Korean National Health and Nutrition Examination Survey 2016–2017

Association between Away-from-Home Meals and Hypertension in Korean adults: Analyzing Data from the Korean National Health and Nutrition Examination Survey 2016–2017

The association between red cell distribution width and incident hypertension in Korean adults.

Red cell distribution width (RDW), a measure of variation in red blood cell size, is routinely reported in the results of a complete blood count. Recent studies have found that RDW is a predictor of high cardiovascular morbidity and mortality. Furthermore, previous cross-sectional studies have shown a possible association between high RDW and hypertension. However, the longitudinal relationship between high RDW and incident hypertension is uncertain. The aim of this study was to investigate the association between RDW and the development of hypertension. In this retrospective cohort study, we analyzed 124,261 participants without hypertension at baseline who underwent two health checkups at 4-year intervals from 2005 to 2016. The subjects were divided into quartiles (Q1-Q4) according to their baseline RDW levels. Multivariate logistic regression was used to estimate the OR and 95% CI for the development of hypertension after 4 years. After 4 years, 6827 cases (5.5%) of incident hypertension were observed. The incidence rates of hypertension were 4.66%, 5.66%, 5.99%, and 5.46% for Q1, Q2, Q3 and Q4 of RDW, respectively. The ORs (95% CIs) for incident hypertension compared with Q1 were 1.19 (1.10-1.29), 1.28 (1.18-1.39), and 1.32 (1.22-1.44) for Q2, Q3, and Q4 of RDW, respectively. High RDW was significantly and independently associated with the development of hypertension in Korean adults. Further research is warranted to verify the mechanism underlying this relationship.

Association of circulating 25-hydroxyvitamin D levels with hypertension and blood pressure values in Korean adults: A Mendelian randomization study on a subset of the Korea National Health and Nutrition Survey 2011-2012 population.

BACKGROUND/OBJECTIVESLower circulating 25-hydroxyvitamin D [25(OH)D] levels are associated with a higher risk of hypertension (HTN); however, it remains unclear whether the relationship is causal. We aimed to evaluate the causal effects of circulating 25(OH)D levels on the prevalence of HTN in the Korean population using the Mendelian randomization (MR) approach.SUBJECTS/METHODSEpidemiological data, serum 25(OH)D data, and genomic DNA biospecimens were obtained from 2,591 participants, a subset of the study population in the Korea National Health and Nutrition Survey 2011-2012. Five 25(OH)D-related single nucleotide polymorphisms (SNPs; DHCR7 rs12785878, CYP2R1 rs10741657, CYP2R1 rs12794714, CYP24A1 rs6013897, and GC rs2282679), identified a priori from genome-wide association studies, were used as instrument variables (IVs) for serum 25(OH)D levels. In the MR analysis, we performed IV analyses using the two-stage least squares method.RESULTSIn the observational analysis, circulating 25(OH)D levels were found to be inversely associated with the HTN prevalence in ordinary least squares models (odds ratio: 0.97, 95% confidence interval: 0.96, 0.99) after adjusting for the potential confounders. There were differences in the circulating 25(OH)D levels across genotypes of individual SNPs. In the MR analysis, using individual SNPs as IVs, 25(OH)D levels were not associated with the HTN prevalence.CONCLUSIONSWe found no association between genetically determined circulating 25(OH)D levels and HTN in Korean adults. Our results are listed owing to the relatively small sample size and possible weak instrument bias; therefore, further studies are needed to confirm these results.

Association between sugar-sweetened beverage consumption and incident hypertension in Korean adults: a prospective study.

Epidemiological information on the association between sugar-sweetened beverage (SSB) consumption and the risk for hypertension (HTN) in Koreans is very limited. We tested the hypothesis that increased SSB consumption is related to a higher risk of HTN among middle-aged Korean adults in a Korean community-based cohort. From participants of the cohort from 2001 to 2010, we selected 5775 subjects without HTN, diabetes, cardiovascular disease, and cancer and who had no information on dietary assessment at baseline. To assess the relationship between SSB consumption and HTN, we estimated hazard ratios (HRs) and 95% confidence intervals using Cox regression analysis. In addition, stratified analysis by body mass index (BMI) was conducted. During the follow-up, we identified 1175 cases of incident HTN. The adjusted HR of HTN for the highest quartile of SSB consumption was 1.21 compared to the lowest quartile. Furthermore, higher consumption of SSB was significantly associated with increased incidence of HTN in subjects with BMI ≥ 25kg/m2, whereas there was no significant association among subjects with BMI < 25kg/m2. The results of this study suggest that SSB consumption was associated with an increased risk of HTN, particularly among obese participants.

Effects of Abdominal Obesity and Risk Drinking on the Hypertension Risk in Korean Adults

Purpose: This study was conducted to investigate the combined effects of abdominal obesity and alcohol drinking on the risk of hypertension in Korean adults (aged ≥30 yrs). Methods: Data of 13,885 subjects from the sixth Korea National Health and Nutrition Examination Survey were analyzed. The multiple logistic regression tests were used for the analysis, including potential covariates of the model. Results: Frequency of drinking, typical drinking quantity, and frequency of binge drinking had a positive relation to hypertension. The odds ratio of hypertension for risk drinkers with abdominal obesity was 4.81 compared to non-risk drinkers with normal waist circumstance, whereas the odds ratios of hypertension for risk drinkers with normal waist circumstance and non-risk drinkers with abdominal obesity were 1.58 and 2.37 respectively. Conclusion: Both abdominal obesity and alcohol drinking patterns were strong risk factors of hypertension in the Korean adults. Risk drinkers with abdominal obesity showed a marked high risk in hypertension compared to those with a single condition alone.

Trends in Blood Pressure and Prevalence of Hypertension in Korean Adults Based on the 1998-2014 KNHANES.

PurposeTo investigate trends in blood pressure (BP) and hypertension prevalence in Korea.Materials and MethodsBased on the Korean National Health and Nutrition Examination Survey (KNHANES) I (1998), II (2001), III (2005), IV (2007–2009), V (2010–2012), and VI (2013–2014), 56077 participants (23974 men and 32103 women) were included.ResultsMean systolic BP (SBP) and diastolic BP (DBP) decreased in both sexes (male SBP: 128.1 to 120.2 mm Hg, male DBP: 82.0 to 78.5 mm Hg; female SBP: 125.7 to 116.0 mm Hg and female DBP: 77.4 to 73.2 mm Hg from the KNHANES I–VI). The age-standardized prevalence of hypertension was significantly decreased in both sexes (male; 33.3% to 30.3%, female; 28.7% to 22.7%, all p for trend <0.001). Regardless of taking anti-hypertensive medication or not, SBP and DBP declined universally in both sexes. Compared to the KNHANES I, the odds ratios (95% confidence intervals) of the KNHANES II to VI for less-than-normotensive and less-than-hypertensive BP increased in both sexes.ConclusionMean BP levels in both sexes and hypertension prevalence showed downward trends during the 16-year period.

Relationship between Grip Strength and Prevalence of Hypertension in Korean Adults: the Sixth Korea National Health and Nutrition Examination Survey(2015)

Relationship between Grip Strength and Prevalence of Hypertension in Korean Adults: the Sixth Korea National Health and Nutrition Examination Survey(2015)

Association between cotinine-verified smoking status and hypertension in 167,868 Korean adults

Purpose: Previous studies showed inconsistent results concerning the relationship between chronic smoking and blood pressure. Most of the studies involved self-reported smoking status. This study was performed to evaluate the association of urinary cotinine or self-reported smoking status with hypertension and blood pressure in Korean adults.Materials and methods: Among individuals enrolled in the Kangbuk Samsung Health Study and Kangbuk Samsung Cohort Study, 167,868 participants (men, 55.7%; age, 37.5 ± 6.9 years) between 2011 and 2013 who had urinary cotinine measurements were included. Individuals with urinary cotinine levels ≥50 ng/mL were defined as cotinine-verified current smokers.Results: The prevalence of hypertension and cotinine-verified current smokers in the overall population was 6.8% and 22.7%, respectively (10.0% in men and 2.8% in women for hypertension: 37.7% in men and 3.9% in women for cotinine-verified current smokers). In a multivariate regression analysis adjusted for age, sex, body mass index, waist circumference, alcohol drinking, vigorous exercise, and diabetes, cotinine-verified current smoking was associated with lower prevalence of hypertension compared with cotinine-verified never smoking (OR[95% CI], 0.79 [0.75, 0.84]). Log-transformed cotinine levels and unobserved smoking were negatively associated with hypertension, respectively (0.96 [0.96, 0.97] and 0.55 [0.39, 0.79]). In a multivariate linear regression analysis, the cotinine-verified current smoking was inversely associated with systolic and diastolic blood pressure (BP) (regression coefficient[95% CI], −1.23[−1.39, −1.07] for systolic BP and −0.71 [−0.84, −0.58] for diastolic BP). In subgroup analyses according to sex, the inverse associations between cotinine-verified current smoking and hypertension were observed only in men.Conclusions: This large observational study showed that cotinine-verified current smoking and unobserved smoking were inversely associated with hypertension in Korean adults, especially only in men.

Abstract MP038: Soft Drink Consumption Increases the Risk of Hypertension in Korean Adults: A Prospective Cohort Study

Introduction: Several previous studies have reported that consumption of soft drink is associated with increased risk of hypertension (HTN) in Western societies. However, epidemiological information on such associations is very limited in Koreans. Hypothesis: We tested the hypothesis whether an increase in soft drink consumption is related to higher risk of HTN among Korean middle aged adults from Korean community based Cohort (Ansan-Ansung cohort). Methods: Data from Ansan-Ansung cohort from 2001 to 2010 in the Korean genome and epidemiology study (KoGES) were used for statistical analyses. Among the participants, we selected 5,296 subjects (2,475 men and 2,821 women, aged 39-64 yrs) who were free from presence of HTN, diabetes, cardiovascular disease and cancer at baseline and those who completely followed up for 10.4 years. Participants who completed a semi-quantitative food frequency questionnaire for dietary assessment and questionnaire for baseline health status in 2001-2002 were included in analyses. Subjects were categorized as quartile based on their soft drink consumption. Soft drink consumption was calculated as frequency per week summed up by consumption frequency of soda (such as Coke and Sprite) and other beverages (including sweet rice drink and Citrus tea). To assess the relationship between soft drink consumption and HTN, we estimated multivariable-adjusted hazard ratio (HR) and 95% confidence intervals (CIs) using cox regression analysis. In addition, stratified analysis by body mass index (BMI) was conducted. Results: During the follow-up period of 10.4 years, we ascertained 1,035 incident cases (19.5% of study population) of HTN. Total soft drink consumption showed significant association with increased risk for HTN after adjusting for potential confounders (age, sex, total energy intake, BMI, and socio-economic factors). The adjusted HR of HTN for the highest quartile of soft drink consumption was 1.24 (95% CIs: 1.02-1.51) compared to the lowest quartile. Furthermore, we found that higher consumption of soft drink was significantly associated with increased incidence of HTN in subjects with BMI ≥25 (HR: 1.54; 95% CIs: 1.15-2.01), whereas there was no significant association among subjects with BMI &lt;25. Conclusions: In conclusion, this study suggested that soft drink consumption contributes to increased risk of HTN, being prominent in obese participants. Our results support recommendations to reduce the consumption of soft drink to prevent and control HTN, although further large prospective studies or randomized controlled trials are warranted to confirm the observed association.

Interaction between Single Nucleotide Polymorphism and Urinary Sodium, Potassium, and Sodium-Potassium Ratio on the Risk of Hypertension in Korean Adults.

Hypertension is a complex disease explained with diverse factors including environmental factors and genetic factors. The objectives of this study were to determine the interaction effects between gene variants and 24 h estimated urinary sodium and potassium excretion and sodium-potassium excretion ratios on the risk of hypertension. A total of 8839 participants were included in the genome-wide association study (GWAS) to find genetic factors associated with hypertension. Tanaka and Kawasaki formulas were applied to estimate 24 h urinary sodium and potassium excretion. A total of 4414 participants were included in interaction analyses to identify the interaction effects of gene variants according to 24 h estimated urinary factors on the risk of hypertension. CSK rs1378942 and CSK-MIR4513 rs3784789 were significantly modified by urinary sodium-potassium excretion ratio. In addition, MKLN rs1643270 with urinary potassium excretion, LOC101929750 rs7554672 with urinary sodium and potassium excretion, and TENM4 rs10466739 with urinary sodium-potassium excretion ratio showed significant interaction effects. The present study results indicated that the mutant alleles of CSK rs1378942 and CSK-MIR4513 rs3784789 had the strongest protective effects against hypertension in the middle group of 24 h estimated urinary sodium-potassium excretion ratio. Further studies are needed to replicate these analyses in other populations.

Association of Sugar-Sweetened Beverages Consumption and Hypertension in Korean Adults: Korean National Health and Nutrition Examination Survey 2012–2013

methods. Results: The prevalence of hypertension in adults with SSB intake ≥7 times/wk was higher than in those with SSB intake <7 times/wk (P<0.001). The multivariate-adjusted odds ratio for hypertension was 10.888 (95% confidence interval, 7.485–15.838) for those with SSB intake of ≥7 times/wk. Conclusion: These findings suggest that increased SSB intake may be associated with hypertension in Korean adults.

The association between resting heart rate and type 2 diabetes and hypertension in Korean adults

ObjectiveThe purpose of this study was to analyse the association between resting heart rate (RHR) and type 2 diabetes and hypertension in Korean adults.MethodsA total of 5124 participants, who participated...

Association of alcohol consumption pattern with risk of hypertension in Korean adults based on the 2010-2012 KNHANES.

We examined the association between alcohol-drinking pattern and hypertension in Korean adults. This cross-sectional study included 15,052 participants (7054 men and 7998 women) who were included in the 2010-2012 Korean National Health and Nutrition Examination Survey (KNHANES). We categorized alcohol-drinking patterns into three groups based on the Alcohol Use Disorders Identification Test (AUDIT) score: low-risk (score: 0-7), intermediate-risk (score: 8-14), and high-risk (score: ≥15). Hypertension was defined as systolic blood pressure ≥140mmHg, diastolic blood pressure ≥90mmHg, or current use of anti-hypertensive medications. In the study population, 25.2% of men and 4.6% of women were high-risk drinkers. Hypertension prevalence was 30.8% in men and 20.6% in women. Of the total population, 13.8% of men and 13.6% of women were using anti-hypertensive drugs. Age-adjusted hypertension prevalence was 30.8, 40.9, and 45.3% in men, and 24.6, 27.0, and 32.3% in women in the low-, intermediate-, and high-risk drinking group, respectively. Compared to the low-risk drinking group, the prevalence ratio (95% confidence interval [CI]) for hypertension was 1.664 (1.4331.933) and 2.070 (1.772-2.418) for men and 1.012 (0.774-1.323) and 1.650 (1.080-2.522) for women in the intermediate- and high-risk drinking group, respectively, after adjusting for age and other confounding factors. In conclusion, our study suggests high-risk drinking appears to be associated with a higher risk of hypertension in men and women.

Association between fried food consumption and hypertension in Korean adults.

The present study explored the relationships between fried food consumption and metabolic risk factors and hypertension in Korean adults. The study was based on the fifth Korean National Health and Nutrition Examination Survey between 2010 and 2011. A total of 9221 Korean adults aged ≥19 years were studied. Fried food consumption was assessed using a validated FFQ. Metabolic risk factors such as waist circumference, fasting plasma glucose (FPG), TAG, HDL-cholesterol and systolic and diastolic blood pressure (SBP and DBP) were measured. Hypertension was defined as SBP≥140 mmHg, DBP≥90 mmHg or current use of antihypertensive medication. Adjusted OR for elevated blood pressure significantly increased in men (OR 1·62; 95% CI 1·11, 2·37; P(trend)=0·0447) and women (OR 2·20; 95% CI 1·21, 4·00; P(trend)=0·0403) with a greater than twice a week consumption of fried food compared with those who rarely consumed fried food. However, fried food consumption was not associated with other metabolic risk factors (abdominal obesity, high FPG, hypertriacylglycerolaemia, low HDL-cholesterol and the metabolic syndrome). The adjusted OR for hypertension increased by 2·4-fold in women (OR 2·37; 95% CI 1·19, 4·72; P(trend)=0·0272) with a greater than twice a week fried food consumption compared with those who rarely consumed it. No significant association was found between fried food consumption and hypertension in men. This study suggests that frequent fried food consumption is associated with hypertension in Korean women. Further studies are needed to investigate the effect of different types of fried foods on hypertension.

The Effects of the Obesity and Physical Activity on the Prevalence of Hypertension in Korean Adults

This study was conducted to assess joint effect of body mass index (BMI) and physical activity with risk of hypertension in middle-aged Koreans. The effects of BMI and physical activity on risk of hypertension were studied using data set of 10,020 subjects aged 40∼69 years in a Korean Genome and Epidemiology Study (KoGES). About 31.8% of men and 30.2% of women had hypertension. Higher BMI was associated with increased risk of hypertension in men and women. However, diverse association of physical activity with hypertension was only detected in women. Inactive women with a BMI≥25 were more likely to have hypertension than active women with a BMI<23 (ORs=3.96, 95% CI; 2.77∼5.67). The present study indicates that regular physical activity and weight control can reduce risk of hypertension in Korean middle-aged women.

Acceptable macronutrient distribution ranges and hypertension

Acceptable macronutrient distribution ranges (AMDRs) for carbohydrate, fat, and protein have been set by considering epidemiological evidences that suggest consumption within these ranges plays a role in reducing risk of chronic diseases. Little evidence has been presented on the relationship between the intake outside the AMDR for macronutrient and hypertension. Therefore, this study was performed to examine the association between the intake outside the AMDR and hypertension in Korean adults. This study was based on data obtained from the fifth Korean National Health and Nutrition Examination Survey. The AMDR for carbohydrate is 55–70%, for fat is 15–25%, and for protein is 7–20% of the energy intake for adults. The subjects who did not meet the AMDRs for carbohydrate, fat and protein were considered to be the non-AMDR group. The odds ratio of the non-AMDR group was 1.25 (95% CI, 1.02–1.53) in the hypertensive subjects without anti-hypertensive medication and 1.25 (95% CI, 1.06–1.48) in the hypertensive subjects with anti-hypertensive medication after adjustment for age, sex, current smoking, heavy drinking, physical inactivity, obesity, diabetes mellitus, dyslipidemia, total energy intake, high sodium intake, and vitamin D deficiency. The intake outside the AMDR was significantly associated with hypertension in Korean adults. The AMDR might be useful nutritional requirement for dietary management of hypertension. In the future, these findings need to be verified through prospective population-based studies.

Eating frequency is inversely associated with blood pressure and hypertension in Korean adults: analysis of the Third Korean National Health and Nutrition Examination Survey

A lower eating frequency (EF) has been suggested to be important in the development of cardiovascular risk factors such as obesity and hyperlipidemia. However, the association between EF and blood pressure (BP) remains unclear. The aim of this study was to explore the association of EF with BP and hypertension after adjusting for confounding variables, including body mass index (BMI) and waist circumference (WC). This cross-sectional study used data from the Third Korean National Health and Nutrition Examination Survey. A total of 4625 subjects aged ≥ 19 years were included. To explore the association of EF with BP and hypertension, we performed multiple linear regression analyses and multiple logistic regression analyses for survey design, respectively. EF was inversely associated with systolic BP (SBP) and diastolic BP (DBP). As EF increased from ≤ 2 to 3, 4 and ≥ 5 times per day, estimated adjusted means of both SBP and DBP decreased, showing a significant linear trend independent of obesity (SBP: 120.66, 120.23, 119.18 and 117.92 mm Hg, respectively; P<0.001; DBP: 78.36, 77.78, 77.25 and 76.50 mm Hg, respectively; P=0.004). The inverse association between EF and hypertension was gradually attenuated and significant after adjustment for confounding variables including BMI and WC (P=0.040). This study suggests that lower EF is significantly associated with higher BP, which may be partially mediated by the effect of central obesity. Further prospective studies are needed to verify this causal relationship.

Higher Prevalence and Awareness, but Lower Control Rate of Hypertension in Patients with Diabetes than General Population: The Fifth Korean National Health and Nutrition Examination Survey in 2011

BackgroundWe investigated the prevalence, awareness, treatment, and control rate of hypertension in Korean adults with diabetes using nationally representative data.MethodsUsing data of 5,105 adults from the fifth Korea National Health and Nutrition Examination Survey in 2011 (4,389 nondiabetes mellitus [non-DM]), 242 newly diagnosed with DM (new-DM), and 474 previously diagnosed with DM (known-DM), we analyzed the prevalence of hypertension (mean systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or use of antihypertensive medication) and control rate of hypertension (blood pressure [BP] <130/80 mm Hg).ResultsThe prevalence of hypertension in diabetic adults was 54.6% (44.4% in new-DM and 62.6% in known-DM, P<0.0001 and P<0.0001, respectively) compared with non-DM adults (26.2%). Compared to non-DM, awareness (85.7%, P<0.001) and treatment (97.0%, P=0.020) rates were higher in known-DM, whereas no differences were found between new-DM and non-DM. Control rate among all hypertensive subjects was lower in new-DM (14.9%), compared to non-DM (35.1%, P<0.001) and known-DM (33.3%, P=0.004). Control rate among treated subjects was also lower in new-DM (25.2%), compared to non-DM (68.4%, P<0.0001) and known-DM (39.9%, P<0.0001).ConclusionHigher prevalence and low control rate of hypertension in adults with diabetes suggest that stringent efforts are needed to control BP in patients with diabetes, particularly in newly diagnosed diabetic patients.

Association between weekend catch-up sleep duration and hypertension in Korean adults

Our objective was to investigate if weekend catch-up sleep is independently related to a decrease in the risk for hypertension in Korean adults. The subjects included 2782 Korean adults ages 19 years and older. Data on demographic variables, sleep duration (weekday and weekend), and hypertension were obtained using questionnaires. Logistic regression analyses were performed to test the association between hypertension and sleep duration (weekday and weekend catch-up sleep duration); we also adjusted for possible covariates. After adjustment for confounding variables, we found that individuals who slept less than 6 hours a night had an increased odds ratio (OR) for hypertension (OR, 1.73; 95% confidence interval [CI], 1.13-2.64) compared to individuals who slept 7 to <8 hours a night. Furthermore, one hour of weekend catch-up sleep was significantly associated with decreased risk for hypertension (OR, 0.83; 95% CI, 0.72-0.95). There were significant differences for groups with and without subjective sleep insufficiency in the association between weekend catch-up sleep duration and the prevalence of hypertension; in addition, the effect of an extra hour of weekend catch-up sleep per night on hypertension was stronger in those subjects who experienced subjective sleep insufficiency (OR, 0.61; 95% CI, 0.46-0.82). Sleeping more on the weekend to compensate for weekday sleep deficit could lower the risk for hypertension in Korean adults, especially in Korean adults who have the subjective symptom of sleep insufficiency.

Dietary pattern and hypertension in Korean adults.

To assess the dietary pattern associated with hypertension and pre-hypertension among Korean male and female adults. Cross-sectional study from a representative sample of the Korean population. The Korea National Health and Nutrition Examination Survey IV, which was conducted in 2007 and 2008. Males and females (n 5308) over the age of 20 years. Scores for three major dietary patterns ('whole food', 'Western' and 'drinking') were generated using a factor analysis of thirty predefined food groups based on the food items consumed. We used polytomous logistic regression analyses to obtain odds ratios and 95% confidence intervals for pre-hypertension and hypertension. Participants with a high drinking pattern score (moderate to high alcohol intake, salted fermented seafood intake) had a significantly higher prevalence of pre-hypertension or hypertension than those with a lower drinking pattern score; odds for the top quintile v. the bottom quintile were OR = 1·56 (95% CI 1·23, 1·99; P trend = 0·001) for pre-hypertension and OR = 3·05 (95% CI 2·12, 4·40; P trend < 0·001) for hypertension. The whole food pattern was not associated with either pre-hypertension or hypertension, while the Western pattern was associated with the prevalence of hypertension only among men. Our finding warrants further prospective studies to examine whether alcohol drinking and salty food consumption increase the risk of developing hypertension in Koreans.