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 out-of BP to your danger of CVD is generally toned down which have expanding decades due to the fact both incidence regarding large BP and you may almost every other CVD exposure circumstances in addition to be more common as we grow old
Inside the South Korea, the fresh new Korean Area off Blood circulation pressure computed to use the previous hypertension standards away from systolic BP/diastolic BP ? mm Hg due to too little obvious evidence for further make use of reducing the blood pressure endurance so you can mm Hg for Koreans. 54 , 55 Depending on the Korean Blood pressure level Truth Sheet 2018, the number of anybody identified as having blood circulation pressure increased out of 3 mil in the 2002 to eight.nine million for the 2016, with just 5.seven billion individuals with suitable and you will persistent antihypertensive cures inside the 2016. 56 The therapy speed enhanced away from twenty two% within the 1998 to 59% when you look at the 2007 also to 61% into the 2016, and control price enhanced of 5% inside 1998 so you can 41% inside the 2007 in order to forty-two% for the 2016. 56 Inside a recent study with the Korean Federal Health insurance and Nutrition Examination Questionnaire, the latest frequency out-of hypertension together with quantity of people who need antihypertensive treatment might be increased, becoming comparable along with other nations. 55 , 57 , 58 Predicated on present knowledge handling implementation of new direction within the several regions, including the United states, Asia, and you may Korea, the new 2017 ACC/AHA hypertension guidance commonly significantly boost the prevalence of hypertension and you may exactly how many customers who need antihypertensive cures initiation and the ones who require medication intensification globally. 57 , 58 , 59 , sixty , 61 , 62 From inside the a recent study regarding the Federal Health and Nourishment Test Questionnaire, with respect to the 2017 ACC/AHA guideline, in contrast to the newest 7th Joint National Committee guideline, the fresh new incidence away from blood pressure levels has grown from 29.9% in order to 45.6%, the newest part of United states people recommended for antihypertensive medication has increased of 34.3% in order to thirty six.2%, and you may 53.4% folks people bringing antihypertensive therapy you desire so much more rigorous reduction in their BP. 59 In case there is Asia, use of 2017 ACC/AHA blood circulation pressure recommendations manage lead to the increment regarding the incidence from blood circulation pressure datingranking.net/tr/paltalk-inceleme off 25% to 50%. 63 It needs to be analyzed when the such as for instance alterations in brand new diagnostic endurance and you will healing needs off so you can mm Hg would raise BP manage as well as related outcome. Future research is together with needed seriously to establish the association anywhere between BP and CVD exposure on young population having varied ethnicity and you may to determine in the event your risk/work with proportion to possess treatment is advantageous within low?exposure category.
Age and intercourse standardization try did with the direct means into the age structure of Korean society, old 20 to 80 decades, in 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.
댓글을 남겨주세요