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Kim D, Jeong H, Kim S, Shin H, Park K, Lee S, Lee H, Lee J, Kim K, Kang S, Lee JH, Jang SY, Lee J, Kim KH, Cho JY, Park J, Park SK, Kim S, Kim K, Lee H. Association between office visit intervals and long-term cardiovascular risk in hypertensive patients. J Clin Hypertens (Greenwich) 2023; 25:748-756. [PMID: 37436657 PMCID: PMC10423752 DOI: 10.1111/jch.14698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/18/2023] [Accepted: 06/27/2023] [Indexed: 07/13/2023]
Abstract
Hypertension is a chronic disease that requires long-term follow-up in many patients, however, optimal visit intervals are not well-established. This study aimed to evaluate the incidences of major cardiovascular events (MACEs) according to visit intervals. We analyzed data from 9894 hypertensive patients in the Korean Hypertension Cohort, which enrolled and followed up 11,043 patients for over 10 years. Participants were classified into five groups based on their median visit intervals (MVIs) during the 4-year period and MACEs were compared among the groups. The patients were divided into clinically relevant MVIs of one (1013; 10%), two (1299; 13%), three (2732; 28%), four (2355; 24%), and six months (2515; 25%). The median follow-up period was 5 years (range: 1745 ± 293 days). The longer visit interval groups did not have an increased cumulative incidence of MACE (12.9%, 11.8%, 6.7%, 5.9%, and 4%, respectively). In the Cox proportional hazards model, those in the longer MVI group had a smaller hazard ratio (HR) for MACEs or all-cause death: 1.77 (95% confidence interval [CI], 1.45-2.17), 1.7 (95% CI: 1.41-2.05), 0.90 (95% CI: 0.74-1.09) and 0.64 (95% CI: 0.52-0.79), respectively (Reference MVI group of 75-104 days). In conclusion, a follow-up visits with a longer interval of 3-6 months was not associated with an increased risk of MACE or all-cause death in hypertensive patients. Therefore, once medication adjustment is stabilized, a longer interval of 3-6 months is reasonable, reducing medical expenses without increasing the risk of cardiovascular outcomes.
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Affiliation(s)
- Duon Kim
- Department of MedicineSeoul National University College of MedicineSeoulSouth Korea
| | - Hyunmook Jeong
- Biomedical Research InstituteSeoul National University HospitalSeoulSouth Korea
| | - Suhyun Kim
- Transdisciplinary Department of Medicine & Advanced TechnologySeoul National University HospitalSeoulSouth Korea
| | - Ho‐Gyun Shin
- National Evidence‐based Healthcare Collaborating Agency (NECA)SeoulSouth Korea
| | - Kyun‐Ik Park
- National Evidence‐based Healthcare Collaborating Agency (NECA)SeoulSouth Korea
| | - Seung‐Pyo Lee
- Department of Internal MedicineSeoul National University HospitalSeoulSouth Korea
| | - Hee‐Sun Lee
- Department of Internal MedicineSeoul National University HospitalSeoulSouth Korea
| | - Ju‐Yeun Lee
- College of PharmacySeoul National UniversitySeoulSouth Korea
| | - Kwang‐il Kim
- Department of Internal MedicineSeoul National University Bundang HospitalSungnamSouth Korea
| | - Si‐Hyuck Kang
- Department of Internal MedicineSeoul National University Bundang HospitalSungnamSouth Korea
| | - Jang Hoon Lee
- Department of Internal MedicineKyungpook National University Hospital, School of MedicineKyungpook National UniversityDaeguSouth Korea
| | - Se Yong Jang
- Department of Internal MedicineKyungpook National University Hospital, School of MedicineKyungpook National UniversityDaeguSouth Korea
| | - Ju‐Hee Lee
- Division of CardiologyDepartment of Internal MedicineChungbuk National University HospitalChungbuk National University College of MedicineCheongjuSouth Korea
| | - Kye Hun Kim
- Department of Cardiovascular MedicineChonnam National University Medical School/HospitalGwangjuSouth Korea
| | - Jae Yeong Cho
- Department of Cardiovascular MedicineChonnam National University Medical School/HospitalGwangjuSouth Korea
| | - Jae‐Hyeong Park
- Department of Internal MedicineChungnam National University College of MedicineDaejeonSouth Korea
| | - Sue K. Park
- Department of Preventive MedicineSeoul National University College of MedicineSeoulSouth Korea
| | - Seungyeon Kim
- College of PharmacyDankook UniversityCheonanSouth Korea
| | - Kwangsoo Kim
- Transdisciplinary Department of Medicine & Advanced TechnologySeoul National University HospitalSeoulSouth Korea
| | - Hae‐Young Lee
- Department of Internal MedicineSeoul National University HospitalSeoulSouth Korea
- Department of Internal MedicineSeoul National University College of MedicineSeoulSouth Korea
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Lee JY, Bak JK, Kim M, Shin HG, Park KI, Lee SP, Lee HS, Lee JY, Kim KI, Kang SH, Lee JH, Jang SY, Lee JH, Kim KH, Cho JY, Park JH, Park SK, Lee HY. Long-term cardiovascular events in hypertensive patients: full report of the Korean Hypertension Cohort. Korean J Intern Med 2023; 38:56-67. [PMID: 36514267 PMCID: PMC9816676 DOI: 10.3904/kjim.2022.249] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/09/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND/AIMS This study evaluated the long-term cardiovascular complications among Korean patients with hypertension and compared them with that of controls without hypertension. METHODS The Korean Hypertension Cohort (KHC) enrolled 11,043 patients with hypertension and followed them for more than 10 years. Age- and sex-matched controls without hypertension were enrolled at a 1:10 ratio. We compared the incidence of cardiovascular events and death among patients and controls without hypertension. RESULTS The mean age was 59 years, and 34.8% and 16.5% of the patients belonged to the high and moderate cardiovascular risk groups, respectively. During the 10-year follow-up, 1,591 cardiovascular events (14.4%) with 588 deaths (5.3%) occurred among patients with hypertension and 7,635 cardiovascular events (6.9%) with 4,826 deaths (4.4%) occurred among controls. Even the low-risk population with hypertension showed a higher cardiovascular event rate than the population without hypertension. Although blood pressure measurements in the clinic showed remarkable inaccuracy compared with those measured in the national health examinations, systolic blood pressure (SBP) ≥ 150 mmHg was significantly associated with a higher risk of cardiovascular events. CONCLUSION This long-term follow-up study confirmed the cardiovascular event rates among Korean hypertensive patients were substantial, reaching 15% in 10 years. SBP levels ≥ 150 mmHg were highly associated with occurrence of cardiovascular event rates.
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Affiliation(s)
- Jin Young Lee
- Department of Applied Statistics, Chung-Ang University, Seoul,
Korea
| | - Jean Kyung Bak
- National Evidence-based Healthcare Collaborating Agency (NECA), Seoul,
Korea
| | - Mina Kim
- Department of Applied Statistics, Chung-Ang University, Seoul,
Korea
| | - Ho-Gyun Shin
- National Evidence-based Healthcare Collaborating Agency (NECA), Seoul,
Korea
| | - Kyun-Ik Park
- National Evidence-based Healthcare Collaborating Agency (NECA), Seoul,
Korea
| | - Seung-Pyo Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul,
Korea
| | - Hee-Sun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul,
Korea
| | - Ju-Yeun Lee
- College of Pharmacy, Seoul National University, Seoul,
Korea
| | - Kwang-il Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul,
Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam,
Korea
| | - Si-Hyuck Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul,
Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam,
Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu,
Korea
| | - Se Yong Jang
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu,
Korea
| | - Ju-Hee Lee
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju,
Korea
| | - Kye Hun Kim
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju,
Korea
| | - Jae Yeong Cho
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon,
Korea
| | - Jae-Hyeong Park
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon,
Korea
| | - Sue K. Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul,
Korea
| | - Hae-Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul,
Korea
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Shin J. Clinical and epidemiological implications of the data on the Korean clinical hypertension cohort. Korean J Intern Med 2023; 38:5-6. [PMID: 36596759 PMCID: PMC9816673 DOI: 10.3904/kjim.2022.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 12/06/2022] [Indexed: 12/29/2022] Open
Affiliation(s)
- Jinho Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University Seoul Hospital, Hanyang University College of Medicine, Seoul, Korea
- Correspondence to Jinho Shin, M.D. Division of Cardiology, Department of Internal Medicine, Hanyang University Seoul Hospital, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdonggu, Seoul 04763, Korea Tel: +82-2-2290-8308 Fax: +82-2-2299-0278 E-mail:
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Rhee EJ. The Promising First Cohort Study in Korean Patients with Obesity and Overweight: Gangwon Obesity and Metabolic Syndrome Study. J Obes Metab Syndr 2022; 31:285-286. [PMID: 36529861 PMCID: PMC9828706 DOI: 10.7570/jomes22068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 12/12/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
- Eun-Jung Rhee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea,Corresponding author Eun-Jung Rhee https://orcid.org/0000-0002-6108-7758 Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea Tel: +82-2-2001-2579 Fax: +82-2-2001-2049 E-mail:
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Heart Failure and Diabetes Mellitus: Dangerous Liaisons. INTERNATIONAL JOURNAL OF HEART FAILURE 2022; 4:163-174. [PMID: 36381018 PMCID: PMC9634025 DOI: 10.36628/ijhf.2022.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 01/25/2023]
Abstract
Patients with diabetes mellitus (DM) have a higher prevalence of heart failure (HF) than those without it. Approximately 40% of HF patients have DM, having poorer outcomes than those without DM. Myocardial ischemia caused by endothelial dysfunction, renal dysfunction, obesity, and impaired myocardial energetics is pathophysiology of DM-induced HF (DM-HF). Also, patients with HF show an increased risk for the onset of DM due to several mechanisms including insulin resistance. This review is focused on the epidemiology, pathogenic mechanism and treatment strategy of DM-HF.
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Park BE, Lee JH, Jang SY, Lee H, Lee J, Shin H, Park K, Lee S, Lee H, Kim K, Kang S, Lee J, Kim KH, Cho JY, Park J, Park SK, Bak JK, Lee JY. Comparison of the efficiency between electrocardiogram and echocardiogram for left ventricular hypertrophy evaluation in patients with hypertension: Insight from the Korean Hypertension Cohort Study. J Clin Hypertens (Greenwich) 2022; 24:1451-1460. [PMID: 36268774 PMCID: PMC9659871 DOI: 10.1111/jch.14583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/04/2022] [Accepted: 09/18/2022] [Indexed: 12/02/2022]
Abstract
In patients with hypertension, left ventricular hypertrophy (LVH) represents a risk factor for cardiovascular disease and asymptomatic organ damage. Currently, electrocardiography (ECG) and two-dimensional echocardiography (Echo) are the most widely used methods for LVH evaluation. This study aimed to compare the long-term outcomes of LVH, as evaluated by ECG and Echo, in patients with hypertension. Patients diagnosed with hypertension as a primary disease between 2006 and 2011 were enrolled in the Korean Hypertension Cohort study. The study finally included 1743 patients who underwent both ECG and Echo. The primary endpoint was defined as the composite of major adverse cardiovascular events (MACEs) or death. Overall, LVH was identified in 747 patients. The patients were categorized into four groups according to the detection of LVH by ECG or Echo: No LVH (n = 996), LVH diagnosed by ECG alone (n = 181), LVH diagnosed by Echo alone (n = 415), LVH diagnosed by both ECG and Echo (n = 151). After adjusting for variables, the incidence of MACEs or death was significantly greater in patients with LVH diagnosed by ECG alone (hazards ratio [HR]: 1.69; 95% confidence interval [CI]: 1.22-2.35; P = .001), LVH diagnosed by Echo alone (HR: 1.54; 95% CI: 1.16-2.05; P = .002), and LVH diagnosed by both ECG and Echo (HR: 1.87; 95% CI: 1.18-2.94; P = .002) than in those with no LVH. Both ECG and Echo are efficient diagnostic tools for LVH and useful for long-term risk stratification. Additional Echo evaluation for LVH is helpful for predicting long-term outcomes only in patients without LVH diagnosis by ECG.
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Affiliation(s)
- Bo Eun Park
- Department of Internal MedicineKyungpook National University HospitalDaeguKorea
| | - Jang Hoon Lee
- Department of Internal MedicineKyungpook National University HospitalDaeguKorea,School of MedicineKyungpook National UniversityDaeguKorea
| | - Se Yong Jang
- Department of Internal MedicineKyungpook National University HospitalDaeguKorea,School of MedicineKyungpook National UniversityDaeguKorea
| | - Hae‐Young Lee
- Department of Internal MedicineSeoul National University HospitalSeoulKorea
| | - Ju‐Yeon Lee
- College of PharmacySeoul National UniversitySeoulKorea
| | - Ho‐Gyun Shin
- National Evidence‐based Healthcare Collaborating Agency (NECA)SeoulKorea
| | - Kyun‐Ik Park
- National Evidence‐based Healthcare Collaborating Agency (NECA)SeoulKorea
| | - Seung‐Pyo Lee
- Department of Internal MedicineSeoul National University HospitalSeoulKorea
| | - Hee‐Sun Lee
- Department of Internal MedicineSeoul National University HospitalSeoulKorea
| | - Kwang‐Il Kim
- Department of Internal MedicineSeoul National University Bundang HospitalSungnamKorea
| | - Si‐Hyuck Kang
- Department of Internal MedicineSeoul National University Bundang HospitalSungnamKorea
| | - Ju‐Hee Lee
- Division of CardiologyDepartment of Internal MedicineChungbuk National University HospitalChungbuk National University College of MedicineCheongjuKorea
| | - Kye Hun Kim
- Department of Cardiovascular MedicineChonnam National University Medical School/HospitalGwangjuKorea
| | - Jae Yeong Cho
- Department of Cardiovascular MedicineChonnam National University Medical School/HospitalGwangjuKorea
| | - Jae‐Hyeong Park
- Department of Internal MedicineChungnam National University College of MedicineDaejeonKorea
| | - Sue K. Park
- Department of Preventive MedicineSeoul National University College of MedicineSeoulKorea
| | - Jean Kyung Bak
- National Evidence‐based Healthcare Collaborating Agency (NECA)SeoulKorea
| | - Jin Young Lee
- Department of StatisticsChung‐ang UniversitySeoulKorea
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Sohn IS. Development of a Korean-specific cardiovascular risk model in a cohort at high-risk of hypertension. Korean J Intern Med 2021; 36:1059-1060. [PMID: 34503317 PMCID: PMC8435495 DOI: 10.3904/kjim.2021.368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 08/12/2021] [Indexed: 11/27/2022] Open
Affiliation(s)
- Il Suk Sohn
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
- Correspondence to Il Suk Sohn, M.D. Department of Cardiology, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul 05278, Korea Tel: + 82-2-440-6108 Fax: +82-2-440-7699 E-mail:
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