151
|
Liu J. Highlights of the 2018 Chinese hypertension guidelines. Clin Hypertens 2020; 26:8. [PMID: 32377372 PMCID: PMC7193361 DOI: 10.1186/s40885-020-00141-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/13/2020] [Indexed: 01/10/2023] Open
Abstract
Background Blood pressure (BP) are uncontrolled in over 80% hypertensive population in China, indicating a compelling need for a pragmatic hypertension management strategy. The 2018 Chinese hypertension guidelines issued in 2019, after 3 years revision. During the periods, the latest United States (US) and European guidelines successively published, bringing new thoughts, wisdoms and schemes on hypertension management. This review aims to summarize the highlights of the new Chinese guidelines. Main text Despite the fact that the 2017 US hypertension guidelines changed hypertension definition from ≥140/90 mmHg to 130/80 mmHg, the Chinese hypertension guidelines did not follow suit, and maintained 140/90 mmHg as the cut-point of for diagnosis of hypertension. A combined, cardiovascular risks and BP levels-based antihypertensive treatment algorithm was introduced. Five classes of antihypertensive drugs, including β-blockers were recommended as initiation and maintenance of BP-lowering therapy. Initiating combination therapy, including single pill combination (SPC) was indicated in high-risk patients or those with grade 2 or 3 hypertension. For those with grade 1 hypertension (BP ≥ 140/90 mmHg), an initial low-dose antihypertensive drugs combination treatment could be considered. Conclusions China has never stopped exploring the best strategy for improving hypertension control. Based on clinical evidence and expertise, the newest Chinese guidelines and expert consensus will be of help in guiding physicians and practitioners to provide better management of hypertension in China.
Collapse
Affiliation(s)
- Jing Liu
- Department of Cardiology, Peking University People's Hospital, Beijing, 100044 China
| |
Collapse
|
152
|
Choi JW, Park JS, Lee CH. Interactive effect of high sodium intake with increased serum triglycerides on hypertension. PLoS One 2020; 15:e0231707. [PMID: 32298354 PMCID: PMC7162459 DOI: 10.1371/journal.pone.0231707] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/30/2020] [Indexed: 11/25/2022] Open
Abstract
Background A high salt diet is associated with the development of hypertension, one of the most important cardiovascular risk factors. A reduction in sodium intake seems to have an effect on increasing serum triglycerides (TGs). Elevated TGs are independently linked to cardiovascular risk. However, there is limited evidence of a possible interactive effect of sodium intake and serum TGs on high blood pressure (BP). Methods We conducted a nationwide, population-based interaction analysis using the Kawasaki method for estimating 24-h urinary sodium excretion (e24hUNaEKawasaki) as a candidate indicator of dietary sodium intake. All native Koreans aged 20 years or older without significant medical illness were eligible for inclusion. Results A total of 16936 participants were divided into quintiles according to their e24hUNaEKawasaki results. Participants in the highest quintile were more obese and hypertensive and had higher white blood cell count, lower hemoglobin, greater glycemic exposure, and poor lipid profiles compared to the same parameters of individuals in other quintiles. Linear regression revealed that e24UNaEKawasaki was related to systolic BP, diastolic BP, and TGs. Multiple logistic regression, adjusted for dietary sodium intake and various conventional risk factors for chronic vascular diseases, showed that both e24UNaEKawasaki and TGs were significant predictors of hypertension. Our interaction analysis demonstrated that increased sodium intake was associated with higher risk of hypertension in participants with elevated TGs than in those without (adjusted RERI = 0.022, 95% CI = 0.017–0.027; adjusted AP = 0.017, 95% CI = 0.006–0.028; adjusted SI = 1.010, 95% CI = 1.007–1.014). Conclusion Our findings suggest that the interaction between a high salt diet and elevated TGs may exert synergistic biological effects on the risk of hypertension.
Collapse
Affiliation(s)
- Jong Wook Choi
- Research Institute of Medical Science, Konkuk University School of Medicine, Chungju, Korea
| | - Joon-Sung Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
- * E-mail: (JSP); (CHL)
| | - Chang Hwa Lee
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
- * E-mail: (JSP); (CHL)
| |
Collapse
|
153
|
Tam HL, Wong EML, Cheung K. Effectiveness of Educational Interventions on Adherence to Lifestyle Modifications Among Hypertensive Patients: An Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072513. [PMID: 32272601 PMCID: PMC7177836 DOI: 10.3390/ijerph17072513] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 03/27/2020] [Accepted: 03/31/2020] [Indexed: 12/20/2022]
Abstract
Controlling blood pressure is a global concern as it is a major risk factor for cardiometabolic diseases and stroke. A flattened control rate was noted in recent decades, which highlighted an issue of adherence to medications and lifestyle modifications. Effectiveness of educational intervention on medication adherence and blood pressure control had been reviewed, but reviews on lifestyle modifications are lacking. This review with meta-analysis aimed to identify the effect of educational interventions on blood pressure control and adherence to lifestyle modifications. In accordance with the PRISMA statement, a search of CINAHL Complete, PubMed, Medline, Embase and Scopus for randomized control trials published between 2009 and 2019 was conducted. Data were extracted for quality synthesis and meta-analysis. Thirteen studies were included. Two forms of educational intervention, individual and group education, were commonly used. Phone calls, message reminders and reading materials after education were identified in the studies as supportive methods, which showed a moderate to large effect on adherence to lifestyle modifications and blood pressure control. Monthly group education lasting 45 min was suggested. Health professionals could integrate the education with supportive methods into community health promotion to improve and reinforce the adherence behavior on medications and lifestyle modifications among hypertensive patients.
Collapse
Affiliation(s)
- Hon Lon Tam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China;
- Education department, Kiang Wu Nursing College of Macau, Macau 999078, China
- Correspondence: (H.L.T.); (E.M.L.W.)
| | - Eliza Mi Ling Wong
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China;
- Correspondence: (H.L.T.); (E.M.L.W.)
| | - Kin Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China;
| |
Collapse
|
154
|
Shim JS, Heo JE, Kim HC. Factors associated with dietary adherence to the guidelines for prevention and treatment of hypertension among Korean adults with and without hypertension. Clin Hypertens 2020; 26:5. [PMID: 32190348 PMCID: PMC7073010 DOI: 10.1186/s40885-020-00138-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 02/07/2020] [Indexed: 01/11/2023] Open
Abstract
Background Although dietary modification is strongly recommended for prevention and treatment of hypertension, little is known about which factors are associated with adherence to dietary guidelines. We investigated knowledge and attitude, perceived benefits of, barriers to, and self-efficacy of dietary therapy, and identified the factors associated with dietary adherence among adults with and without hypertension. Methods We collected information on the knowledge/attitudes and perceived benefits of dietary therapy, as well as barriers to and self-efficacy regarding dietary adherence from 497 middle-aged (34–69 years) adults who participated in the follow-up examination of the Cardiovascular and Metabolic Diseases Etiology Center (CMERC) cohort study during December 2018 and February 2019. Results Among people without hypertension, 95.5% (343/359) and 95.8% (344/359) answered that they would limit sodium intake and consume health diet, respectively, if diagnosed hypertension. However, among people with hypertension, only 79.7% (110/138) and 77.5% (107/138) reported they were limiting dietary sodium intake and having healthy diet, respectively. Frequency of diet management was not different between normotensive (34.0%) and hypertensive (35.5%) groups. Compared to normotensives, hypertensive people were more likely to have lower dietary adherence score, think they need to change their diet, think dietary change impossible, and report lower self-efficacy for following diet guidelines. Dietary management was significantly associated with cardiometabolic risk factors (OR: 1.63) and dietary education (OR: 2.19) among normotensives, while it was associated only with awareness that lifestyle modification is necessary regardless of antihypertensive medication (OR: 6.29) among hypertensive people. Good dietary adherence had significant associations with perceived barriers (OR: 0.71), self-efficacy (OR: 3.71), and dietary education (OR: 1.98) among normotensives; and with perceived barriers (OR: 0.54), self-efficacy (OR: 4.06), and dietary management (OR: 4.16) among hypertensive people. Conclusions Many Koreans have relatively low adherence to dietary guidelines for hypertension prevention and treatment. Knowledge, dietary practices, and factors affecting dietary adherence were different between adults with and without hypertension. A targeted approach will be needed to improve blood pressure control of the Korean population.
Collapse
|
155
|
Real-world efficacy and safety of nebivolol in Korean patients with hypertension from the BENEFIT KOREA study. J Hypertens 2020; 38:527-535. [DOI: 10.1097/hjh.0000000000002296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
156
|
Shin J, Kario K, Chia Y, Turana Y, Chen C, Buranakitjaroen P, Divinagracia R, Nailes J, Hoshide S, Siddique S, Sison J, Soenarta AA, Sogunuru GP, Tay JC, Teo BW, Zhang Y, Park S, Van Minh H, Kabutoya T, Verma N, Wang T, Wang J. Current status of ambulatory blood pressure monitoring in Asian countries: A report from the HOPE Asia Network. J Clin Hypertens (Greenwich) 2020; 22:384-390. [PMID: 31696632 PMCID: PMC8030038 DOI: 10.1111/jch.13724] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 09/19/2019] [Indexed: 08/02/2023]
Abstract
Ambulatory blood pressure monitoring (ABPM) can measure 24-hour blood pressure (BP), including nocturnal BP and diurnal variations. This feature of ABPM could be of value in Asian populations for preventing cardiovascular events. However, no study has yet investigated regarding the use of ABPM in actual clinical settings in Asian countries/regions. In this study, 11 experts from 11 countries/regions were asked to answer questionnaires regarding the use of ABPM. We found that its use was very limited in primary care settings and almost exclusively available in referral settings. The indications of ABPM in actual clinical settings were largely similar to those of home BP monitoring (HBPM), that is, diagnosis of white-coat or masked hypertension and more accurate BP measurement for borderline clinic BP. Other interesting indications, such as nighttime BP patterns, including non-dipper BP, morning BP surge, and BP variability, were hardly adopted in daily clinical practice. The use of ABPM as treatment guidance for detecting treated but uncontrolled hypertension in the Asian countries/regions didn't seem to be common. The barrier to the use of ABPM was primarily its availability; in referral centers, patient reluctance owing to discomfort or sleep disturbance was the most frequent barrier. ABPM use was significantly more economical when it was reimbursed by public insurance. To facilitate ABPM use, more simplified indications and protocols to minimize discomfort should be sought. For the time being, HBPM could be a reasonable alternative.
Collapse
Affiliation(s)
- Jinho Shin
- Division of CardiologyDepartment of Internal MedicineHanyang University Medical CenterSeoulKorea
| | - Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Yook‐Chin Chia
- Department of Medical SciencesSchool of Healthcare and Medical SciencesSunway UniversityBandar SunwayMalaysia
- Department of Primary Care MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Yuda Turana
- Faculty of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Chen‐Huan Chen
- Department of MedicineSchool of MedicineNational Yang‐Ming UniversityTaipeiTaiwan
| | - Peera Buranakitjaroen
- Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Romeo Divinagracia
- University of the East Ramon Magsaysay Memorial Medical Center Inc.Quezon CityPhilippines
| | - Jennifer Nailes
- University of the East Ramon Magsaysay Memorial Medical Center Inc.Quezon CityPhilippines
| | - Satoshi Hoshide
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | | | - Jorge Sison
- Section of CardiologyDepartment of MedicineMedical Center ManilaManilaPhilippines
| | - Arieska Ann Soenarta
- Department of Cardiology and Vascular MedicineFaculty of MedicineUniversity of Indonesia‐National Cardiovascular Center, Harapan KitaJakartaIndonesia
| | - Guru Prasad Sogunuru
- MIOT International HospitalChennaiIndia
- College of Medical SciencesKathmandu UniversityBharatpurNepal
| | - Jam Chin Tay
- Department of General MedicineTan Tock Seng HospitalSingapore CitySingapore
| | - Boon Wee Teo
- Division of Nephrology Department of MedicineYong Loo Lin School of MedicineSingapore CitySingapore
| | - Yu‐Qing Zhang
- Divisions of Hypertension and Heart FailureFu Wai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Sungha Park
- Division of CardiologyCardiovascular HospitalYonsei Health SystemSeoulKorea
| | - Huynh Van Minh
- Department of Internal MedicineUniversity of Medicine and PharmacyHue UniversityHue CityVietnam
| | - Tomoyuki Kabutoya
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Narsingh Verma
- Indian Society of HypertensionKing George's Medical UniversityLucknowIndia
| | - Tzung‐Dau Wang
- Department of Internal MedicineNational Taiwan University College of MedicineTaipei CityTaiwan
| | - Ji‐Guang Wang
- Department of HypertensionCentre for Epidemiological Studies and Clinical TrialsThe Shanghai Institute of HypertensionShanghai Key Laboratory of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| |
Collapse
|
157
|
Chia Y, Kario K, Turana Y, Nailes J, Tay JC, Siddique S, Park S, Shin J, Buranakitjaroen P, Chen C, Divinagracia R, Hoshide S, Minh HV, Sison J, Soenarta AA, Sogunuru GP, Sukonthasarn A, Teo BW, Verma N, Zhang Y, Wang T, Wang J. Target blood pressure and control status in Asia. J Clin Hypertens (Greenwich) 2020; 22:344-350. [PMID: 31742891 PMCID: PMC8029870 DOI: 10.1111/jch.13714] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 09/10/2019] [Indexed: 11/29/2022]
Abstract
It is widely accepted that hypertension constitutes a significant cardiovascular risk factor and that treating high blood pressure (BP) effectively reduces cardiovascular risk. An important issue in Asia is not just the high prevalence of hypertension, particularly in some countries, but also the low level of awareness and treatment rates in many regions. The 2017 update of the American College of Cardiology/American Heart Association hypertension guidelines raised the question about which BP threshold should be used to diagnose and treat hypertension. Although there is a theoretical rationale for a stricter BP criterion in Asia given the ethnic-specific features of hypertension in the region, the majority of countries in Asia have retained a diagnostic BP threshold of ≥140/90 mm Hg. Although lowering thresholds might make theoretical sense, this would increase the prevalence of hypertension and also markedly reduce BP control rates. In addition, there are currently no data from robust randomized clinical trials of the benefits of the lower targets in preventing cardiovascular disease and reducing cardiovascular risk, particularly in high-risk patients and especially for Asian populations. There is also no defined home BP treatment target level for an office BP treatment target of 130/80 mm Hg. However, in this regard, in the interim, lifestyle modifications, including reducing body weight and salt intake, should form an important part of hypertension management strategies in Asia, while studies on treating at lower BP threshold level in Asians and getting to lower BP targets will be helpful to inform and optimize the management of hypertension in the region.
Collapse
Affiliation(s)
- Yook‐Chin Chia
- Department of Medical SciencesSchool of Healthcare and Medical SciencesSunway UniversityBandar SunwayMalaysia
- Department of Primary Care MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Yuda Turana
- Department of NeurologyFaculty of MedicineAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Jennifer Nailes
- University of the East Ramon Magsaysay Memorial Medical Center IncQuezon CityPhilippines
| | - Jam Chin Tay
- Department of General MedicineTan Tock Seng HospitalSingapore CitySingapore
| | | | - Sungha Park
- Division of CardiologyCardiovascular HospitalYonsei Health SystemSeoulKorea
| | - Jinho Shin
- Faculty of Cardiology ServiceHanyang University Medical CenterSeoulKorea
| | - Peera Buranakitjaroen
- Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Chen‐Huan Chen
- Department of MedicineFaculty of MedicineNational Yang‐Ming UniversityTaipeiTaiwan
| | - Romeo Divinagracia
- University of the East Ramon Magsaysay Memorial Medical Center IncQuezon CityPhilippines
| | - Satoshi Hoshide
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Huynh Van Minh
- Department of Internal MedicineUniversity of Medicine and PharmacyHue UniversityHueVietnam
| | - Jorge Sison
- Department of MedicineMedical Center ManilaManilaPhilippines
| | - Arieska Ann Soenarta
- Department Cardiology and Vascular MedicineUniversity of Indonesia‐National Cardiovascular CenterHarapan KitaJakartaIndonesia
| | - Guru Prasad Sogunuru
- MIOT International HospitalChennaiIndia
- College of Medical SciencesKathmandu UniversityBharatpurNepal
| | | | - Boon Wee Teo
- Division of NephrologyDepartment of MedicineYong Loo Lin School of MedicineNational University of SingaporeSingapore CitySingapore
| | - Narsingh Verma
- Department of PhysiologyFaculty of MedicineKing George's Medical UniversityLucknowIndia
| | - Yuqing Zhang
- Divisions of Hypertension and Heart FailureFu Wai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Tzung‐Dau Wang
- Division of CardiologyDepartment of Internal MedicineNational Taiwan University Hospital and College of MedicineNational Taiwan UniversityTaipeiTaiwan
| | - Ji‐Guang Wang
- Department of HypertensionCentre for Epidemiological Studies and Clinical TrialsThe Shanghai Institute of HypertensionShanghai Key Laboratory of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| |
Collapse
|
158
|
Shin J, Cho MC. Updated Reasons and Clinical Implications of New Korean Hypertension Guidelines for Cardiologists. Korean Circ J 2020; 50:476-484. [PMID: 32281319 PMCID: PMC7234851 DOI: 10.4070/kcj.2019.0338] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/18/2020] [Indexed: 11/29/2022] Open
Abstract
Leaving behind substantial reflections or skepticisms on the shortage of evidences about blood pressure (BP) thresholds for antihypertensive drug therapy and target BPs, major hypertensive guidelines including Korean hypertension guidelines were recently updated for earlier and more intensive control of BP. Because hypertension is one of the major risk factors for death, stroke, cardiovascular (CV) disease, heart failure, and cognitive impairment, substantial improvement of hypertension management is necessary to reduce disease and socioeconomic burdens and to promote CV health. Theoretically, earlier intervention in terms of age and BP level and thorough control of BP into within normal range would prevent or delay major adverse CV events. Revised hypertension guidelines were developed by the American College of Cardiology/American Heart Association, Korean Society of Hypertension, European Society of Cardiology/European Society of Hypertension, and Japanese Society of Hypertension in order. In this article, recent updates and clinical significances of the Korean hypertension guidelines will be discussed with comparison of foreign hypertension guidelines and considerable changes in the management of hypertension will be introduced for cardiologists and general practitioners.
Collapse
Affiliation(s)
- Jinho Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University Hospital, Seoul, Korea
| | - Myeong Chan Cho
- Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea.
| |
Collapse
|
159
|
Kwun JS, Kim SH, Kang SH, Yoon CH, Lee HY, Kim KI, Youn TJ, Chae IH, Kim CH. Potential impact of 2018 Korean Society of Hypertension guidelines on Korean population: a population-based cohort study. Clin Hypertens 2020; 26:3. [PMID: 32021699 PMCID: PMC6995175 DOI: 10.1186/s40885-020-0137-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 01/12/2020] [Indexed: 02/03/2023] Open
Abstract
Background The Korean Society of Hypertension (KSH) revised the local guidelines for hypertension in 2018. The present study sought to evaluate the potential impact of the 2018 KSH guidelines on hypertension management status among the Korean population in terms of prevalence of hypertension, antihypertensive medical treatment recommendations, and control status in Korean adults. Methods We used data from the Korea National Health and Nutrition Examination Survey to estimate the number and percentage of Korean adults who have hypertension according to blood pressure (BP) classification, are recommended to receive antihypertensive medical treatment, and are receiving medical treatment and have BP in the optimal range according to the new recommendations. Adults aged 30 years or older who participated in the survey between 2013 and 2015 were selected for this study. Results The prevalence of hypertension was 30.5% among Korean adults aged 30 years or older. The percentage of subjects who are recommended to be treated with antihypertensive medications substantially increased from 32.5 to 37.8%, which translates to 1.6 million adults. Among the hypertensive patients who were receiving medical treatment, 38.6% were shown to have adequate BP levels as recommended by the 2018 KSH guidelines compared with 51.8% according to the previous 2013 guidelines. Conclusions The present study reports the potential impact of the 2018 KSH guidelines on the prevalence of hypertension, antihypertensive medical treatment recommendations, and control status for Korean adults. The 2018 KSH guidelines recommend more intensive BP control compared with previous guidelines. This study suggests that there is large scope for improvement in hypertension management in the Korean population.
Collapse
Affiliation(s)
- Ju-Seung Kwun
- 1Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do 13620 South Korea.,2Department of Internal Medicine, Seoul National University, Seoul, South Korea
| | - Sun-Hwa Kim
- 1Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do 13620 South Korea
| | - Si-Hyuck Kang
- 1Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do 13620 South Korea.,2Department of Internal Medicine, Seoul National University, Seoul, South Korea
| | - Chang-Hwan Yoon
- 1Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do 13620 South Korea.,2Department of Internal Medicine, Seoul National University, Seoul, South Korea
| | - Hae-Young Lee
- 2Department of Internal Medicine, Seoul National University, Seoul, South Korea.,3Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea
| | - Kwang-Il Kim
- 2Department of Internal Medicine, Seoul National University, Seoul, South Korea
| | - Tae-Jin Youn
- 1Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do 13620 South Korea.,2Department of Internal Medicine, Seoul National University, Seoul, South Korea
| | - In-Ho Chae
- 1Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do 13620 South Korea.,2Department of Internal Medicine, Seoul National University, Seoul, South Korea
| | - Cheol-Ho Kim
- 2Department of Internal Medicine, Seoul National University, Seoul, South Korea
| |
Collapse
|
160
|
Abstract
Background Hypertension is a leading cause of cardiovascular disease, stroke, and death. It affects a substantial proportion of the population worldwide, and remains underdiagnosed and undertreated. Body Long-standing high blood pressure leads to left ventricular hypertrophy and diastolic dysfunction that cause an increase in myocardial rigidity, which renders the myocardium less compliant to changes in the preload, afterload, and sympathetic tone. Adequate blood pressure control must be achieved in patients with hypertension to prevent progression to overt heart failure. Controlling blood pressure is also important in patients with established heart failure, especially among those with preserved ejection fractions. However, aggressive blood pressure lowering can cause adverse outcomes, because a reverse J-curve association may exist between the blood pressure and the outcomes of patients with heart failure. Little robust evidence exists regarding the optimal blood pressure target for patients with heart failure, but a value near 130/80 mmHg seems to be adequate according to the current guidelines. Conclusion Prospective studies are required to further investigate the optimal blood pressure target for patients with heart failure.
Collapse
Affiliation(s)
- Gyu Chul Oh
- Cardiovascular Center & Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, South Korea
| | - Hyun-Jai Cho
- Cardiovascular Center & Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, South Korea
| |
Collapse
|
161
|
Kim J, Hoang T, Bu SY, Kim JM, Choi JH, Park E, Lee SM, Park E, Min JY, Lee IS, Youn SY. Associations of Dietary Intake with Cardiovascular Disease, Blood Pressure, and Lipid Profile in the Korean Population: a Systematic Review and Meta-Analysis. J Lipid Atheroscler 2020; 9:205-229. [PMID: 32821732 PMCID: PMC7379076 DOI: 10.12997/jla.2020.9.1.205] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Previous studies have separately reported the contributions of dietary factors to the risk of cardiovascular disease (CVD) and its markers, including blood pressure (BP) and lipid profile. This study systematically reviewed the current evidence on this issue in the Korean population. METHODS Sixty-two studies from PubMed and Embase were included in this meta-analysis. We performed a random-effects model to analyze pooled odds ratios (ORs) and hazard ratios (HRs) and their 95% confidence intervals (CIs) for the consumption of 14 food items, three macro- and eight micro-nutrients, two dietary patterns, and three dietary indices. RESULTS An analysis of pooled effect sizes from at least four individual study populations showed significant associations between coffee consumption and CVD (OR/HR, 0.71; 95% CI, 0.52-0.97) and elevated/high triglycerides (TG) (OR, 0.84; 95% CI, 0.78-0.90), sugar-sweetened beverage intake and elevated BP (OR/HR, 1.20; 95% CI, 1.09-1.33), and milk and dairy intake and elevated/high TG and low high-density lipoprotein cholesterol (HDL-C) (OR/HR, 0.82; 95% CI, 0.76-0.89 for both). Carbohydrate consumption and the low-carbohydrate-diet score were consistently related to an approximately 25% risk reduction for elevated TG and low HDL-C. A lower risk of elevated total cholesterol, but not low-density lipoprotein, was additionally observed for those with a higher low-carbohydrate-diet score. A healthy dietary pattern was only associated with a reduced risk of elevated TG in the Korea National Cancer Screenee Cohort (OR, 0.81; 95% CI, 0.67-0.98). CONCLUSION This study showed that milk and dairy and coffee had protective effects for CVD and its risk factors, such as BP and lipid profile, while sugar-sweetened beverages exerted harmful effects.
Collapse
Affiliation(s)
- Jeongseon Kim
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Tung Hoang
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - So Young Bu
- Department of Food and Nutrition, Daegu University, Gyeongsan, Korea
| | - Ji-Myung Kim
- Food and Nutrition Major, Division of Food Science and Culinary Arts, Shinhan University, Uijeongbu, Korea
| | - Jeong-Hwa Choi
- Department of Food and Nutrition, Keimyung University, Daegu, Korea
| | - Eunju Park
- Department of Food and Nutrition, Kyungnam University, Changwon, Korea
| | - Seung-Min Lee
- Department of Food and Nutrition, Yonsei University, Seoul, Korea
| | - Eunmi Park
- Department of Food and Nutrition, Hannam University, Daejeon, Korea
| | - Ji Yeon Min
- Dietetics and Nutrition Services Team, Asan Medical Center, Seoul, Korea
| | - In Seok Lee
- Nutrition Support Team, Kyung Hee University Medical Center, Seoul, Korea
| | - So Young Youn
- Clinical Nutrition Part, Samsung Medical Center, Seoul, Korea
| |
Collapse
|
162
|
Koracevic G, Stojanovic M, Kostic T, Lovic D, Tomasevic M, Jankovic-Tomasevic R. Unsolved Problem: (Isolated) Systolic Hypertension with Diastolic Blood Pressure below the Safety Margin. Med Princ Pract 2020; 29:301-309. [PMID: 32380500 PMCID: PMC7445659 DOI: 10.1159/000508462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/21/2020] [Indexed: 11/19/2022] Open
Abstract
The problem of high systolic blood pressure (sBP) combined with low diastolic blood pressure (dBP) requires attention because sBP is directly and continuously related to the most important criterion, i.e., all-cause mortality, whereas dBP becomes inversely related to it after the age of 50-60 years. The European Society of Cardiology and European Society of -Hypertension (ESC/ESH) 2018 guidelines for hypertension (HTN) are helpful because they recommend a lower safety cut-off for in-treatment dBP. To prevent tissue hypoperfusion, these guidelines recommend that dBP should be ≥70 mm Hg during treatment. A patient with very elevated sBP (e.g., 220 mm Hg) and low dBP (e.g., 65 mm Hg) is difficult to treat if one strictly follows the guidelines. In this situation, the sBP is a clear indication for antihypertensive treatment, but the dBP is a relative contraindication (as it is <70 mm Hg, a safety margin recognized by the 2018 ESC/ESH guidelines). The dilemma about whether or not to treat isolated systolic hypertension (SH) patients with low dBP (<70 mm Hg) is evident from the fact that almost half (45%) remain untreated. This is a common occurrence and identifying this problem is the first step to solving it. We suggest that an adequate search and analysis should be performed, starting from the exploration of the prognosis of the isolated (I)SH subset of patients with a very low dBP (<70 mm Hg) at the beginning of already performed randomized clinical trials.
Collapse
Affiliation(s)
- Goran Koracevic
- Department for Cardiovascular Diseases, Clinical Center Nis, Nis, Serbia
- Faculty of Medicine, University of Nis, Nis, Serbia
| | - Milovan Stojanovic
- Institute for Treatment and Rehabilitation Niska Banja, Niska Banja, Serbia,
| | - Tomislav Kostic
- Department for Cardiovascular Diseases, Clinical Center Nis, Nis, Serbia
- Faculty of Medicine, University of Nis, Nis, Serbia
| | - Dragan Lovic
- Clinic for Internal Diseases Intermedica, Nis, Serbia
| | - Miloje Tomasevic
- Department of Cardiology, Clinical Center of Serbia, Belgrade, Serbia
| | | |
Collapse
|
163
|
Lee HY. Big Challenge in Big Data Research: Continual Dispute on Big Data Analysis. Korean Circ J 2019; 50:69-71. [PMID: 31854157 PMCID: PMC6923239 DOI: 10.4070/kcj.2019.0349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 11/20/2019] [Indexed: 02/03/2023] Open
Affiliation(s)
- Hae Young Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
| |
Collapse
|
164
|
Shim JS, Jung SJ, Kim HC. Self-reported diet management, dietary quality, and blood pressure control in Korean adults with hypertension. Clin Hypertens 2019; 25:24. [PMID: 31890276 PMCID: PMC6911701 DOI: 10.1186/s40885-019-0130-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 10/18/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Hypertension control is a major public health concern. Daily preventive practices of the affected individual are essential for controlling blood pressure (BP). We investigated the association of diet management practice, dietary quality, and BP control among Korean adults with known hypertension. METHODS We included 4107 participants aged 40-79 years who reported physician-diagnosed hypertension in the Korea National Health and Nutrition Examination Survey 2013-2016. Dietary management practice was defined by self-report, and dietary intakes were assessed by a 24-h dietary recall. Dietary quality and adherence were evaluated based on the Korean Healthy Eating Index (KHEI) using food and nutrient intakes assessed by a 24-h dietary recall. BP control was defined as systolic/diastolic BP < 140/90 mmHg. RESULTS While the prevalence of dietary management was higher in women than men, BP control rate was not different by sex. Dietary management practice had no significant association with BP control in both men and women. Only in men, dietary quality was positively associated with BP control (OR: 1.10 per KHEI 10 score increase, 95% CI: 1.00-1.20, p-value = 0.04). Men who had a highly adherent diet seemed to have a higher possibility of BP control, but there was no statistical significance (OR: 1.54, 95% CI: 0.84-2.81, p-value = 0.16). CONCLUSIONS A high-quality diet was positively associated with BP control in Korean men aware of their hypertension. Our findings highlight the beneficial impact of dietary management as a means for achieving blood pressure control.
Collapse
Affiliation(s)
- Jee-Seon Shim
- Department of Preventive Medicine, Yonsei University College of Medicine, Yonse-ro 50-1, Seodaemun-gu, 03722 Seoul, Republic of Korea
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Yonse-ro 50-1, Seodaemun-gu, 03722 Seoul, Republic of Korea
| | - Sun Jae Jung
- Department of Preventive Medicine, Yonsei University College of Medicine, Yonse-ro 50-1, Seodaemun-gu, 03722 Seoul, Republic of Korea
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave. #505, Boston, MA 02115 USA
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Yonse-ro 50-1, Seodaemun-gu, 03722 Seoul, Republic of Korea
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Yonse-ro 50-1, Seodaemun-gu, 03722 Seoul, Republic of Korea
| |
Collapse
|
165
|
Mehta RT, Pareek A, Dharmadhikari S. Compelling therapy of LVH: straight (and not-so-straight) inferences from evidence. Clin Hypertens 2019; 25:25. [PMID: 31807315 PMCID: PMC6857286 DOI: 10.1186/s40885-019-0131-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 10/18/2019] [Indexed: 11/10/2022] Open
Abstract
We have read with interest the Korean Society of Hypertension guidelines for the management of hypertension and congratulate the Society for an extensive review of literature while drafting the guidelines. The guidelines indicate preferring ACE-I and CCB over diuretics in patients with left ventricle hypertrophy. However, in landmark head-to-head comparison trials, the thiazide-like diuretic chlorthalidone has been shown to be superior to ACE-I and CCB in decreasing left ventricle mass and preventing heart failure in hypertensive patients. Also, we put forth the paradoxical finding that mere regression of LVH may not always translate into reduction in risk of HF; and that the pleiotropic effects of chlorthalidone may be the explanation behind its beneficial action in HF.
Collapse
Affiliation(s)
- Ravi Tejraj Mehta
- Ipca Laboratories Limited, Kandivli Industrial Estate, Kandivli (West), Mumbai, Maharashtra India
| | - Anil Pareek
- Ipca Laboratories Limited, Kandivli Industrial Estate, Kandivli (West), Mumbai, Maharashtra India
| | - Shruti Dharmadhikari
- Ipca Laboratories Limited, Kandivli Industrial Estate, Kandivli (West), Mumbai, Maharashtra India
| |
Collapse
|
166
|
Yang E, Lee S, Lee H, Hwang I, Jang IJ, Yu KS, Lee S. Pharmacokinetic comparison between fixed-dose combination of fimasartan/amlodipine 60/10 mg and the corresponding loose combination through partial replicated crossover study in healthy subjects. Transl Clin Pharmacol 2019; 27:134-140. [PMID: 32095481 PMCID: PMC7032963 DOI: 10.12793/tcp.2019.27.4.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/29/2019] [Accepted: 12/01/2019] [Indexed: 11/19/2022] Open
Abstract
Combination therapies of antihypertensive drugs are recommended in cases where hypertension is not controlled by monotherapy. This study aimed to compare the pharmacokinetics (PKs) between fixed-dose combination (FDC) of fimasartan/amlodipine 60/10 mg and the corresponding loose combination. Because of the high intra-subject variability for maximum plasma concentration (Cmax) of fimasartan, a randomized, open-label, 3×3 partial replicated crossover design was adopted. Subjects received a single dose of FDC of fimasartan/amlodipine 60/10 mg or the corresponding loose combination in each period. Blood samples for PK analysis were collected up to 48 hours for fimasartan and 144 hours for amlodipine, respectively. Geometric mean ratios (GMRs) and its 90% confidence intervals (CIs) of the FDC to the loose combination for Cmax and area under the concentration-time curve from time 0 to the last quantifiable time point (AUClast) were calculated. Sixty healthy subjects were randomized, and 57 subjects completed the study. The concentration-time profiles of fimasartan and amlodipine were similar between the FDC and loose combination. The GMRs (90% CIs) of the FDC to the loose combination for Cmax and AUClast were 1.0440 (0.9202-1.1844) and 1.0412 (0.9775-1.1090) for fimasartan, and 1.0430 (1.0156-1.0711) and 1.0339 (1.0055-1.0631) for amlodipine, respectively. The GMRs and its 90% CIs for Cmax and AUClast of fimasartan and amlodipine were included not only in the scaled bioequivalence criteria but also in the conventional bioequivalence criteria. In conclusion, FDC of fimasartan/amlodipine 60/10 mg showed comparable PK profiles with the corresponding loose combination, which suggests their bioequivalence.
Collapse
Affiliation(s)
- Eunsol Yang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 03080, Republic of Korea
| | - Soyoung Lee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 03080, Republic of Korea
| | - Heechan Lee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 03080, Republic of Korea
| | - Inyoung Hwang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 03080, Republic of Korea
| | - In-Jin Jang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 03080, Republic of Korea
| | - Kyung-Sang Yu
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 03080, Republic of Korea
| | - SeungHwan Lee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 03080, Republic of Korea
| |
Collapse
|
167
|
Cho SMJ, Lee H, Kim HC. Differences in prevalence of hypertension subtypes according to the 2018 Korean Society of Hypertension and 2017 American College of Cardiology/American Heart Association guidelines: The Korean National Health and Nutrition Examination Survey, 2007-2017 (KNHANES IV-VII). Clin Hypertens 2019; 25:26. [PMID: 31819805 PMCID: PMC6885311 DOI: 10.1186/s40885-019-0129-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 10/18/2019] [Indexed: 12/22/2022] Open
Abstract
Background The significance of high systolic and diastolic blood pressure remains controversial. We assessed the differences in prevalence of hypertension and its subtypes according to the different hypertension diagnostic criteria embodied by the 2017 American College of Cardiology/American Heart Association (2017 ACC/AHA) and 2018 Korean Society of Hypertension (2018 KSH) guidelines. Methods We used the 2007–2017 Korea National Health and Nutrition Examination Survey (KNHANES) data to calculate guideline-specific hypertension prevalence among untreated, adult participants. By the 2017 ACC/AHA guideline, a mean SBP ≥130 mmHg, DBP ≥80 mmHg, or currently using antihypertensive medications were considered to have hypertension. Isolated diastolic hypertension (IDH) was defined as DBP ≥80 mmHg and SBP <130 mmHg, isolated systolic hypertension (ISH) as SBP ≥130 mmHg and DBP <80 mmHg, and systolic diastolic hypertension (SDH) as SBP ≥130 mmHg and DBP ≥80 mmHg. In a similar manner, by the 2018 KSH guideline, all hypertension and its subtype prevalence were calculated using the 140/90 mmHg cutoff. The two versions of all hypertension and its corresponding subtype prevalence were calculated among all study participants and separately by sex and age then compared via analysis of variance. Results The prevalence of all hypertension increased from 25.9% (95% confidence interval (CI) 25.4–26.5) defined by the 2018 KSH guideline to 46.3% (95% CI 45.6–46.9) classified by the 2017 ACC/AHA guideline. Such increase was primarily manifested through substantial increase in IDH prevalence, from 5.2% (95% CI 4.9–5.4) defined by the 2018 KSH guideline to 17.9% (95% CI 17.4–18.3) defined by the 2017 ACC/AHA guideline, and was most notably observed in young age groups, 30-49 years. ISH prevalence showed minimal differences. SDH prevalence moderately increased from 3.5% (95% CI 3.3–3.7) defined by the 2018 KSH guideline to 11.1% (95% CI 10.7–11.4) defined by the 2017 ACC/AHA guideline, achieved primarily among participants aged 50 years or above. Conclusions Changes in each subtype prevalence made differential contribution to additionally classified hypertension cases by the 2017 ACC/AHA guideline. Future studies should investigate the diastolic-associated cardiovascular risks and benefits of its long-term primary prevention in the young population.
Collapse
Affiliation(s)
- So Mi Jemma Cho
- 1Department of Public Health, Yonsei University Graduate School, Seoul, Korea.,2Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, 03722 Republic of Korea
| | - Hokyou Lee
- 2Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, 03722 Republic of Korea.,3Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyeon Chang Kim
- 2Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, 03722 Republic of Korea
| |
Collapse
|
168
|
2017 ACC/AHA Blood Pressure Classification and Cardiovascular Disease in 15 Million Adults of Age 20-94 Years. J Clin Med 2019; 8:jcm8111832. [PMID: 31683957 PMCID: PMC6912685 DOI: 10.3390/jcm8111832] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 10/08/2019] [Accepted: 10/28/2019] [Indexed: 01/22/2023] Open
Abstract
The 2017 American College of Cardiology/American Heart Association (ACC/AHA) high blood pressure (BP) guideline lowered the cut-off for hypertension, but its age-specific association with cardiovascular disease (CVD) remains inconclusive in different populations. We evaluated the association between high BP according to the 2017 ACC/AHA guideline and CVD risks in Koreans aged 20-94 years. In a nationwide health screening cohort, we included 15,508,537 persons aged 20-94 years without prior CVD. BP was categorized into normal, elevated, stage 1 hypertension, or stage 2 hypertension. The primary outcome was a composite CVD hospitalization (myocardial infarction, stroke, and/or heart failure). Over 10 years of follow-up, CVD incidence rates per 100,000 person-years were 105.4, 168.3, 215.9, and 641.2 for normal, elevated BP, stage 1, and stage 2 hypertension, respectively. The age-specific hazard ratios of stage 1 hypertension compared to normal BP were 1.41 (1.34-1.48) at ages 20-34, 1.54 (1.51-1.57) at ages 35-49, 1.38 (1.35-1.40) at ages 50-64, 1.21 (1.19-1.24) at ages 65-79, and 1.11 (1.03-1.19) at ages 80-94 years. With the lowered BP cut-off, 130/80 mmHg, population attributable fraction for CVD was 32.2%. In conclusion, stage 1 hypertension was significantly associated with a higher CVD risk across entire adulthood. The new definition of hypertension may have a substantial population impact on primary CVD prevention.
Collapse
|
169
|
Lee S, Cho A, Kwon Y, Jung D. Body fat change and 8‐year incidence of hypertension: Korean Genome and Epidemiology Study. J Clin Hypertens (Greenwich) 2019; 21:1849-1857. [DOI: 10.1111/jch.13723] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/28/2019] [Accepted: 10/07/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Sung‐Bum Lee
- Department of Family Medicine Yonsei University College of Medicine, Gang-nam Severance Hospital Seoul South Korea
| | - A‐Ra Cho
- Department of Family Medicine Yonsei University College of Medicine, Gang-nam Severance Hospital Seoul South Korea
| | - Yu‐Jin Kwon
- Department of Medicine Graduate School of Yonsei University College of Medicine Seoul South Korea
- Department of Family Medicine Yonsei University College of Medicine, Yong-in Severance Hospital Gyeonggi-do South Korea
| | - Dong‐Hyuk Jung
- Department of Family Medicine Yonsei University College of Medicine, Yong-in Severance Hospital Gyeonggi-do South Korea
| |
Collapse
|
170
|
Focused Update of 2016 Korean Society of Heart Failure Guidelines for the Management of Chronic Heart Failure. ACTA ACUST UNITED AC 2019; 1:4-24. [PMID: 36262736 PMCID: PMC9536670 DOI: 10.36628/ijhf.2019.0002] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 09/04/2019] [Accepted: 09/10/2019] [Indexed: 12/29/2022]
Abstract
The incidence of heart failure (HF) is increasing in South Korea and devising the optimal care plan is crucial to promote appropriate and effective treatment of HF. To this end, the first Korean guideline for management of chronic HF was published in 2016 by the HF research group under the Korean Society of Cardiology (KSC). After this publication, considerable data have been accumulated and a new guideline for the management of HF was published in Europe, and an update regarding pharmacological therapy was published in the United States, which made it warrant to update the Korean guideline. Under this premise, The Clinical Practice Guidelines Committee under the Korean Society of Heart Failure (KSHF) founded in 2018 decided to publish a focused update management guideline for chronic HF and selected 15 topics that need an update regarding the diagnosis, definition, diagnostic algorithm, monitoring, novel biomarkers, drug therapy related to non-vitamin K antagonist oral anticoagulants and angiotensin receptor neprilysin inhibitors, and with respect to comorbidities changes in the guidelines of relevant institutions, such as new guidelines for the management of hypertension, a procedure used to treat severe aortic stenosis, information on sodium glucose co-transporter-2 inhibitor, and that about sleep apnea. Among nonpharmacological therapies, changes to the recommendations for implantable cardioverter defibrillator, cardiac resynchronization therapy, and cardiac rehabilitation were updated. Subsequent and continuous updates based on additional clinical research findings, with continual supervision by the KSHF will be needed.
Collapse
|
171
|
Cho MC. Clinical Significance and Therapeutic Implication of Nocturnal Hypertension: Relationship between Nighttime Blood Pressure and Quality of Sleep. Korean Circ J 2019; 49:818-828. [PMID: 31456375 PMCID: PMC6713830 DOI: 10.4070/kcj.2019.0245] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 07/31/2019] [Indexed: 12/11/2022] Open
Abstract
Recent global hypertension guidelines recommend an early, strict and 24-hour blood pressure (BP) control for the prevention of target organ damage and cardiovascular events. Out-of-office BP measurement such as ambulatory BP monitoring and home BP monitoring is now widely utilized to rule out white-coat hypertension, to detect masked hypertension, to evaluate the effects of antihypertensive medication, to analyze diurnal BP variation, and to increase drug adherence. Nocturnal hypertension has been neglected in the management of hypertension despite of its clinical significance. Nighttime BP and non-dipping patterns of BP are stronger risk predictors for the future cardiovascular mortality and morbidity than clinic or daytime BP. In addition to ambulatory or home daytime BP and 24-hour mean BP, nocturnal BP should be a new therapeutic target for the optimal treatment of hypertension to improve prognosis in hypertensive patients. This review will provide an overview of epidemiology, characteristics, and pathophysiology of nocturnal hypertension and clinical significance, therapeutic implication and future perspectives of nocturnal hypertension will be discussed.
Collapse
Affiliation(s)
- Myeong Chan Cho
- Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea.
| |
Collapse
|