Korean Circ J.  2020 Jun;50(6):485-498. 10.4070/kcj.2019.0347.

Comparison and Implication of the Contemporary Blood Pressure Guidelines on Korean Population

Affiliations
  • 1Department of Public Health, Yonsei University Graduate School, Seoul, Korea
  • 2Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
  • 3Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

Abstract

Background and Objectives
This study compared the potential impacts of the 2017 American College of Cardiology/American Heart Association (ACC/AHA) and the 2018 Korean Society of Hypertension (KSH) guidelines on prevalence of hypertension, recommended antihypertensive treatment, and achievement of target blood pressure (BP) in Korean population.
Methods
We analyzed the 2007–2017 Korea National Health and Nutrition Examination Survey data to calculate guideline-specific hypertension prevalence and treatment implications on 59,767 adults aged 20 years or older by sex and age.
Results
The prevalence of hypertension was markedly higher 46.3% by the ACC/AHA guideline due to the lowered BP cutoff than 25.9% by the KSH guideline; the increase was most pronounced in young adults. Yet, there was only a marginal 1.6% increase in the percentage of adults suggested pharmacological approach by the ACC/AHA guideline, but selectively in the older subgroups. Overall, 45.6% of Korean adults treated for hypertension failed to meet BP goal according to the KSH guideline; the underachievement extended to 61.7% of participants according to the ACC/AHA guideline.
Conclusions
The lowered BP threshold, 130/80 mmHg, by the 2017 ACC/AHA guideline, in conjuncture with 10-year risk calculation largely driven by age, would increase pharmacological treatment preferentially in very old individuals, while increasing prevalence and uncontrolled rate mostly in younger subgroups. Adoption of lower BP cutoff to the KSH guideline would require validated cardiovascular disease risk assessment tools accounting for risk distributions specific to Korean population.

Keyword

Hypertension; Blood pressure; Prevalence; Guideline; Cardiovascular diseases

Figure

  • Figure 1 Number and percent of participants with hypertension, recommendation for pharmacological antihypertensive treatment, and BP above goal among study participants according to the 2017 ACC/AHA and the 2018 KSH guidelines. Treatment recommendation based on the KRPM.ACC/AHA = American College of Cardiology/American Heart Association; BP = blood pressure; KRPM = Korean Risk Prediction Model; KSH = Korean Society of Hypertension.

  • Figure 2 Percentage of participants with SBP of 130–139 mmHg or DBP of 80–89 mmHg recommended for antihypertensive medication according to the 2017 ACC/AHA guideline. A 10-year predicted risk for ASCVD is based on the KRPM.ACC/AHA = American College of Cardiology/American Heart Association; ASCVD = atherosclerotic cardiovascular disease; DBP = diastolic blood pressure; KNHANES = Korean National Health and Nutrition Examination Survey; KRPM = Korean Risk Prediction Model; SBP = systolic blood pressure.


Cited by  2 articles

Factors Associated with Awareness, Treatment, and Control Rate of Hypertension among Korean Young Adults Aged 30–49 Years
Yong Woo Jeon, Hyeon Chang Kim
Korean Circ J. 2020;50(12):1077-1091.    doi: 10.4070/kcj.2020.0208.

Sex- and Age-Specific Trends in Cardiovascular Health in Korea, 2007–2018
So Mi Jemma Cho, Hokyou Lee, Hyeon Chang Kim
Korean Circ J. 2021;51(11):922-935.    doi: 10.4070/kcj.2021.0211.


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