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 result from BP into the danger of CVD can be diluted with broadening ages as the both prevalence out of highest BP and you may other CVD exposure circumstances including become more common as we grow older
During the Southern area Korea, new Korean People away from Blood circulation pressure determined to utilize the last blood pressure level conditions off systolic BP/diastolic BP ? mm Hg because of deficiencies in clear facts for additional make the most of lowering the blood pressure levels endurance to help you mm Hg for Koreans. 54 , 55 According to Korean Blood pressure Reality Sheet 2018, the number of some one diagnosed with blood circulation pressure improved out of 3 mil for the 2002 to eight.nine mil into the 2016, with just 5.eight billion people who have suitable and you will persistent antihypertensive medication when you look at the 2016. 56 The treatment speed increased of 22% when you look at the 1998 so you can 59% for the 2007 in order to 61% within the 2016, additionally the control rates improved from 5% from inside the 1998 to help you 41% for the 2007 and to 44% from inside the 2016. 56 Within the a recent study utilizing the Korean Federal Health and Nourishment Examination Questionnaire, the fresh new incidence of blood circulation pressure as well as the quantity of grownups who require antihypertensive cures will be enhanced, getting equivalent along with other places. 55 , 57 , 58 Predicated on previous studies handling implementation of brand new guidelines into the multiple regions, such as the You, Asia, and Korea, the brand new 2017 ACC/AHA blood pressure levels direction tend to markedly increase the prevalence away from blood pressure level and you can what number of customers who upforit require antihypertensive procedures initiation and the ones who require cures intensification in the world. 57 , 58 , 59 , sixty , 61 , 62 During the research conducted recently in the Federal Health and Nutrients Test Survey, depending on the 2017 ACC/AHA guideline, compared to the new Seventh Combined Federal Panel guideline, the fresh new frequency regarding hypertension has increased off 29.9% in order to forty five.6%, the newest part of Us adults suitable for antihypertensive treatment has increased away from 34.3% to thirty-six.2%, and 53.4% of us adults getting antihypertensive cures you prefer more rigorous decline in its BP. 59 In case there is China, use of 2017 ACC/AHA blood circulation pressure guidelines perform lead to the increment from the prevalence out-of blood pressure level regarding twenty-five% to help you 50%. 63 It ought to be evaluated in the event that such as for example alterations in the latest diagnostic tolerance and healing objectives away from so you’re able to mm Hg create boost BP handle and its relevant benefit. Coming scientific studies are along with necessary to confirm the association anywhere between BP and you can CVD chance in the young people having diverse ethnicity and you will to determine if your exposure/work for proportion to have treatment solutions are favorable within reduced?exposure category.
This and you can sex standardization is did using the head method to the many years structure of your Korean inhabitants, old 20 so you can 80 ages, around 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.