Korean Circ J.  2020 May;50(5):432-440. 10.4070/kcj.2019.0230.

Self-Reported Diet Management and Adherence to Dietary Guidelines in Korean Adults with Hypertension

Affiliations
  • 1Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea. hckim@yuhs.ac
  • 2Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea.
  • 3Division of Health and Nutrition Survey, Centers for Disease Control and Prevention, Cheongju, Korea.
  • 4Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Abstract

BACKGROUND AND OBJECTIVES
Although dietary management is strongly recommended in patients with hypertension, little is known about how many manage their diet and follow the guidelines for hypertension. We investigated the prevalence of dietary management among adults with known hypertension and evaluated their compliance to the dietary guidelines.
METHODS
Data from the Korea National Health and Nutrition Examination Survey 2013-2016 were used. Among 15,870 adults aged 30-79 years, 4,162 reported a physician-diagnosed hypertension. Diet management behavior was defined by self-report response. Actual dietary intake was assessed by a 24-hour dietary recall. Dietary quality was evaluated using the Korean Healthy Eating Index (KHEI).
RESULTS
Among adults with hypertension, 28.0% reported that they were managing their diet. Those with hypertension consumed significantly less dietary sodium (p value<0.01), but also less potassium (p value<0.01), resulting in no difference of sodium-to-potassium ratio compared to those without hypertension (p value=0.66). Among those with hypertension, diet-managing adults had better KHEI score (66.9, p value<0.01) and consumed less sodium (3,354.3 mg, p value<0.01) than not-managing adults (63.6 score and 3,554.5 mg, respectively). However, total KHEI score was rather lower in those with hypertension (p value<0.01) than those without hypertension and their sodium intake was still over the recommended amount.
CONCLUSIONS
More than two-thirds of Korean adults with hypertension did not manage their diet in daily life. More effective strategies are needed to increase the level of compliance with dietary recommendations for people with high blood pressure.

Keyword

Hypertension; Dietary guideline; Diet therapy; Self-care

MeSH Terms

Adult*
Compliance
Diet Therapy
Diet*
Eating
Humans
Hypertension*
Korea
Nutrition Policy*
Nutrition Surveys
Potassium
Prevalence
Self Care
Sodium
Sodium, Dietary
Potassium
Sodium
Sodium, Dietary

Cited by  5 articles

Solvitur Ambulando: Importance of Exercise in Middle-Age for Cardiovascular Health
Hae-Young Lee
Korean Circ J. 2021;51(11):936-938.    doi: 10.4070/kcj.2021.0308.

Ultra-Processed Foods as a Less-Known Risk Factor in Cardiovascular Diseases
Hae-Young Lee
Korean Circ J. 2021;52(1):71-73.    doi: 10.4070/kcj.2021.0362.

Consumption of Ultra-Processed Food and Blood Pressure in Korean Adults
Sun Young Shim, Hyeon Chang Kim, Jee-Seon Shim
Korean Circ J. 2021;52(1):60-70.    doi: 10.4070/kcj.2021.0228.

Ultra-Processed Foods as a Less-Known Risk Factor in Cardiovascular Diseases
Hae-Young Lee
Korean Circ J. 2021;52(1):71-73.    doi: 10.4070/kcj.2021.0362.

Reimbursement of Digital Therapeutics: Future Perspectives in Korea
Jin Han Ju, Boram Sim, Jeongeun Lee, Jin Yong Lee
Korean Circ J. 2022;52(4):265-279.    doi: 10.4070/kcj.2022.0014.


Reference

1. O'Brien E. The Lancet Commission on hypertension: addressing the global burden of raised blood pressure on current and future generations. J Clin Hypertens (Greenwich). 2017; 19:564–568. PMID: 28560771.
2. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R. Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002; 360:1903–1913. PMID: 12493255.
3. Rapsomaniki E, Timmis A, George J, et al. Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1·25 million people. Lancet. 2014; 383:1899–1911. PMID: 24881994.
4. da Silva TL, Klein CH, Nogueira AR, Salis LH, de Souza E Silva NA, Bloch KV. Cardiovascular mortality among a cohort of hypertensive and normotensives in Rio de Janeiro - Brazil - 1991–2009. BMC Public Health. 2015; 15:623. PMID: 26152148.
5. Puato M, Boschetti G, Rattazzi M, et al. Intima-media thickness remodelling in hypertensive subjects with long-term well-controlled blood pressure levels. Blood Press. 2017; 26:48–53. PMID: 27216375.
6. Lee HY, Park JB. The Korean Society of Hypertension guidelines for the management of hypertension in 2013: its essentials and key points. Pulse (Basel). 2015; 3:21–28. PMID: 26587454.
7. Davis CR, Hodgson JM, Woodman R, Bryan J, Wilson C, Murphy KJ. A Mediterranean diet lowers blood pressure and improves endothelial function: results from the MedLey randomized intervention trial. Am J Clin Nutr. 2017; 105:1305–1313. PMID: 28424187.
8. Dauchet L, Kesse-Guyot E, Czernichow S, et al. Dietary patterns and blood pressure change over 5-y follow-up in the SU.VI.MAX cohort. Am J Clin Nutr. 2007; 85:1650–1656. PMID: 17556705.
9. Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM. Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. Hypertension. 2006; 47:296–308. PMID: 16434724.
10. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Hypertension. 2018; 71:e13–115. PMID: 29133356.
11. Shrivastava SR, Shrivastava PS, Ramasamy J. Role of self-care in management of diabetes mellitus. J Diabetes Metab Disord. 2013; 12:14. PMID: 23497559.
12. Appel LJ. Lifestyle modification as a means to prevent and treat high blood pressure. J Am Soc Nephrol. 2003; 14:S99–102. PMID: 12819311.
13. Kwan MW, Wong MC, Wang HH, et al. Compliance with the dietary approaches to stop hypertension (DASH) diet: a systematic review. PLoS One. 2013; 8:e78412. PMID: 24205227.
14. Kweon S, Kim Y, Jang MJ, et al. Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES). Int J Epidemiol. 2014; 43:69–77. PMID: 24585853.
15. Yun S, Oh K. Development and status of Korean Healthy Eating Index for adults based on the Korea National Health and Nutrition Examination Survey. Public Health Wkly Rep. 2018; 11:1764–1772.
16. The Korean Society of Hypertension. 2013 Guidelines for treatment of hypertension [Internet]. Seoul: The Korean Society of Hypertension;2013. cited 2020 Jan 14. Available from: http://www.koreanhypertension.org/reference/guide.
17. Lee C, Kim DI, Hong J, et al. Cost-benefit analysis of sodium intake reduction policy in Korea. Korean J Community Nutr. 2012; 17:341–352.
18. Lee H, Park S, Kim HC. Temporal and geospatial trends of hypertension management in Korea: a nationwide study 2002–2016. Korean Circ J. 2019; 49:514–527. PMID: 30808085.
19. Korea Centers for Disease Control and Prevention. Education materials: hypertension and diabetes counseling manual 2019 [Internet]. Cheongju: Korea Centers for Disease Control and Prevention;2019. cited 2020 Jan 14. Available from: http://www.cdc.go.kr/board.es?mid=a20503050000&bid=0021&act=view&list_no=127643.
20. Korea Academy of Medical Sciences, Korea Centers for Disease Control and Prevention. Evidence-based guideline for hypertension in primary care 2014 [Internet]. Cheongju: Korea Academy of Medical Sciences, Korea Centers for Disease Control and Prevention;2014. cited 2020 Jan 14. Available from: http://www.cdc.go.kr/board.es?mid=a20503050000&bid=0021&act=view&list_no=127643.
21. Khan MS, Bawany FI, Mirza A, Hussain M, Khan A, Lashari MN. Frequency and predictors of non-compliance to dietary recommendations among hypertensive patients. J Community Health. 2014; 39:732–736. PMID: 24452406.
22. Kyngäs H, Lahdenperä T. Compliance of patients with hypertension and associated factors. J Adv Nurs. 1999; 29:832–839. PMID: 10215974.
23. Lawson M, Jackson SH, Turner P. An investigation of the relationship between compliance with antihypertensive therapy and the type A behaviour pattern. J Hypertens Suppl. 1991; 9:S50–1. PMID: 1819009.
24. Salomaa V, Vartiainen E, Korhonen HJ, et al. Sydän- ja verisuonitautien vaaratekijät verenpainepotilailla ja muussa väestössä vuosina 1982–1992. Suom Laakaril. 1994; 49:1926–1932.
25. Ayala C, Fang J, Yuan K. Prevalence of taking actions to control blood pressure among adults with self-reported hypertension in 18 states and the District of Columbia, 2009. J Clin Hypertens (Greenwich). 2015; 17:172–182. PMID: 25644363.
26. Willett W. Nutritional epidemiology. Oxford: Oxford University Press;2012.
Full Text Links
  • KCJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2023 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr