J Korean Med Sci.  2011 Oct;26(10):1286-1292. 10.3346/jkms.2011.26.10.1286.

Incidence of Hypertension in Korea: 5-Year Follow-up Study

• Lee JH
• Yang DH
• Park HS
• Cho Y
• Jun JE
• Park WH
• Chun BY
• Shin JY
• Shin DH
• Lee KS
• Kim KS
• Kim KB
• Kim YJ
• Chae SC
• The HYpertension-Diabetes Daegu Initiative Study Investigators

• KMID: 1785984
• DOI: http://doi.org/10.3346/jkms.2011.26.10.1286

Abstract

Limited data are available about the incidence of hypertension over the 5-yr in non-hypertensive subjects. The study subjects were 1,806 subjects enrolled in a rural area of Daegu, Korea for a cohort study from August to November 2003. Of them, 1,287 (71.3%) individuals had another examination 5 yr later. To estimate the incidence of hypertension, 730 non-hypertensive individuals (265 males; mean age = 56.6 +/- 11.1 yr-old) at baseline examination were analyzed in this study. Hypertension was defined as either a new diagnosis of hypertension or self-reports of newly initiated antihypertensive treatment; prehypertension was if the systolic blood pressure was 120-139 mmHg and/or diastolic blood pressure was 80-89 mmHg. During the 5-yr follow-up, 195 (26.7%) non-hypertensive individuals developed incident hypertension. The age-adjusted 5-yr incidence rates of hypertension were 22.9% (95% confidence interval [CI] = 19.9-29.0) in overall subjects, 22.2% (95% CI = 17.2-27.2) in men, and 24.3% (95% CI = 20.4-28.2) in women. The incidence rates of hypertension significantly increased with age. In the multivariate analysis, prehypertension (Odds ratio [OR] 2.25; P < 0.001) and older age (OR 2.26; P = 0.010) were independent predictors for incident hypertension. In this rapidly aging society, population-based preventive approach to decrease blood pressure, particularly in subjects with prehypertension, is needed to reduce hypertension.

Keyword

Hypertension; Blood pressure; Incidence; Population

MeSH Terms

Adult
Age Factors
Aged
Antihypertensive Agents/administration & dosage/*therapeutic use
*Blood Pressure
Blood Pressure Determination
Body Weights and Measures
Cohort Studies
Female
Follow-Up Studies
Humans
Hypertension/diagnosis/drug therapy/*epidemiology/physiopathology
Incidence
Male
Middle Aged
Questionnaires
Republic of Korea/epidemiology
Risk Factors

Figure

• 

  Fig. 1 Incidence of systolic hypertension by age and gender in overall (A), normotensive (B), and prehypertensive subjects (C).

• 

  Fig. 2 Incidence of diastolic hypertension by age and gender in overall (A), normotensive (B), and prehypertensive subjects (C).

Reference

1. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ. National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National High Blood Pressure Education Program Coordinating Committee. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003. 289:2560–2572.

2. Rodriguez BL, Labarthe DR, Huang B, Lopez-Gomez J. Rise of blood pressure with age: new evidence of population differences. Hypertension. 1994. 24:779–785.

3. Burt VL, Whelton P, Roccella EJ, Brown C, Cutler JA, Higgins M, Horan MJ, Labarthe D. Prevalence of hypertension in the US adult population: results from the third national health and nutrition examination survey, 1988-1991. Hypertension. 1995. 25:305–313.

4. D'Agostino RB Sr, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. 2008. 117:743–753.

5. Klag MJ, Whelton PK, Randall BL, Neaton JD, Brancati FL, Ford CE, Shulman NB, Stamler J. Blood pressure and end-stage renal disease in men. N Engl J Med. 1996. 334:13–18.

6. Stokes J 3rd, Kannel WB, Wolf PA, D'Agostino RB, Cupples LA. Blood pressure as a risk factor for cardiovascular disease. The Framingham Study: 30 years of follow-up. Hypertension. 1989. 13:5 Suppl. I13–I18.

7. Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ. Comparative Risk Assessment Collaborating Group. Selected major risk factors and global and regional burden of disease. Lancet. 2002. 360:1347–1360.

8. Kearney PM, Whelton M, Reynolds K, Whelton PK, He J. Worldwide prevalence of hypertension: a systematic review. J Hypertens. 2004. 22:11–19.

9. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005. 365:217–223.

10. Pereira M, Lunet N, Azevedo A, Barros H. Differences in prevalence, awareness, treatment and control of hypertension between developing and developed countries. J Hypertens. 2009. 27:963–975.

11. Cornoni-Huntley J, LaCroix AZ, Havlik RJ. Race and sex differentials in the impact of hypertension in the United States. The National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. Arch Intern Med. 1989. 149:780–788.

12. Kannel WB, Garrison RJ, Dannenberg AL. Secular blood pressure trends in normotensive persons: the Framingham Study. Am Heart J. 1993. 125:1154–1158.

13. Vasan RS, Larson MG, Leip EP, Kannel WB, Levy D. Assessment of frequency of progression to hypertension in non-hypertensive participants in the Framingham Heart Study: a cohort study. Lancet. 2001. 358:1682–1686.

14. Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat. World population prospects: the 2008 revision. 2009. New York: UN Secretariat.

15. Le CN. "Population Statistics & Demographics" Asian-Nation: The Landscape of Asian America. accessed 16 June, 2010. Available at http://www.asian-nation.org/population.shtml.

16. Kim JS, Jones DW, Kim SJ, Hong YP. Hypertension in Korea: a national survey. Am J Prev Med. 1994. 10:200–204.

17. Jo I, Ahn Y, Lee J, Shin KR, Lee HK, Shin C. Prevalence, awareness, treatment, control and risk factors of hypertension in Korea: the Ansan study. J Hypertens. 2001. 19:1523–1532.

18. Burt VL, Cutler JA, Higgins M, Horan MJ, Labarthe D, Whelton P, Brown C, Roccella EJ. Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population: data from the health examination surveys, 1960 to 1991. Hypertension. 1995. 26:60–69.

19. Kastarinen MJ, Salomaa VV, Vartiainen EA, Jousilahti PJ, Tuomilehto JO, Puska PM, Nissinen AM. Trends in blood pressure levels and control of hypertension in Finland from 1982 to 1997. J Hypertens. 1998. 16:1379–1387.

20. Wu X, Duan X, Gu D, Hao J, Tao S, Fan D. Prevalence of hypertension and its trends in Chinese populations. Int J Cardiol. 1995. 52:39–44.

21. Kinsella K, He W. U.S. Census Bureau, International Population Reports, P95/09-1, An Aging World: 2008. 2009. Washington DC: U.S.: Government Printing Office.

22. Kim J, Kim E, Yi H, Joo S, Shin K, Kim J, Kimm K, Shin C. Short-term incidence rate of hypertension in Korea middle-aged adults. J Hypertens. 2006. 24:2177–2182.

23. Sekikawa A, Kuller LH, Ueshima H, Park JE, Suh I, Jee SH, Lee HK, Pan WH. Coronary heart disease mortality trends in men in the post World War II birth cohorts aged 35-44 in Japan, South Korea and Taiwan compared with the United States. Int J Epidemiol. 1999. 28:1044–1049.

24. Hong KS. Prehypertension. Korean Circ J. 2008. 38:1–6.

25. Kim YM, Hong KS, Choi YH, Choi MG, Jeong JY, Lee JM, Kim DH. Rates and related factors of progression to hypertension among prehypertensive local residents aged 45 or over in Chuncheon City: Hallym Aging Study from a Community-Based Cross-Sectional Study. Korean Circ J. 2008. 38:43–50.

26. Natali A, Muscelli E, Casolaro A, Nilsson P, Melander O, Lalic N, Ferrannini E, Petrie JR. Metabolic characteristics of prehypertension: role of classification criteria and gender. J Hypertens. 2009. 27:2394–2402.

27. Perry HM Jr, Miller JP. Difficulties in diagnosing hypertension: implications and alternatives. J Hypertens. 1992. 10:887–896.

28. Weissfeld JL, Kuller LH. Methodologic evaluation of incidence rates for hypertension: calculated for Pittsburgh's MRFIT usual care men. J Chronic Dis. 1985. 38:915–925.

29. Kristman V, Manno M, Côté P. Loss to follow-up in cohort studies: how much is too much? Eur J Epidemiol. 2004. 19:751–760.