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 outcome out-of BP for the threat of CVD could be diluted which have broadening ages just like the both the prevalence from higher BP and you will most other CVD risk products together with be much more common with age
Within the Southern area Korea, the new Korean Neighborhood regarding Hypertension calculated to utilize the earlier hypertension standards off systolic BP/diastolic BP ? mm Hg due to a lack of obvious facts for additional take advantage of reducing the hypertension tolerance in order to mm Hg to possess Koreans. 54 , 55 According to the Korean Blood pressure level Facts Layer 2018, what amount of someone diagnosed with blood circulation pressure improved away from 3 mil during the 2002 to kaynak 8.nine billion within the 2016, with only 5.eight mil people who have suitable and you may chronic antihypertensive treatment inside 2016. 56 The procedure price increased from twenty two% when you look at the 1998 to help you 59% inside the 2007 and also to 61% when you look at the 2016, in addition to control rates enhanced off 5% during the 1998 in order to 41% inside the 2007 in order to 49% during the 2016. 56 Within the a recent study making use of the Korean National Health insurance and Diet Examination Survey, the fresh prevalence out of blood pressure level and number of grownups who require antihypertensive cures would be enhanced, becoming comparable with other places. 55 , 57 , 58 Considering latest knowledge dealing with implementation of the fresh new recommendations inside the multiple places, for instance the United states, China, and you may Korea, this new 2017 ACC/AHA blood pressure level recommendations will significantly improve the incidence off blood circulation pressure and how many patients who want antihypertensive procedures initiation and those who need treatment intensification international. 57 , 58 , 59 , 60 , 61 , 62 Into the a recent study about Federal Health insurance and Diet Test Survey, according to 2017 ACC/AHA rule, compared to the latest 7th Joint National Committee guideline, the new frequency off blood pressure has grown regarding 31.9% to help you forty five.6%, the brand new part of You adults suitable for antihypertensive medication has grown from 34.3% to help you thirty-six.2%, and 53.4% people people delivering antihypertensive therapy you need so much more intensive decline in its BP. 59 In case there are Asia, adoption of your own 2017 ACC/AHA blood pressure level guidance carry out resulted in increment about prevalence away from blood pressure of twenty-five% to 50%. 63 It must be evaluated in the event the like alterations in the brand new symptomatic endurance and you will therapeutic targets out-of to mm Hg manage raise BP manage and its own related lead. Upcoming scientific studies are along with wanted to show new relationship anywhere between BP and you may CVD exposure regarding younger society which have varied ethnicity and to decide should your chance/work with proportion to possess treatment is positive contained in this reduced?exposure class.
The age and you can sex standardization is actually did with the direct method to your decades framework of your own Korean population, old 20 so you can 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.