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 outcome off BP into threat of CVD may be diluted which have growing years given that both prevalence from large BP and other CVD exposure circumstances and additionally become more prevalent as we grow old
For the Southern area Korea, the latest Korean Neighborhood from Blood pressure computed to utilize the previous blood pressure levels criteria off systolic BP/diastolic BP ? mm Hg due to deficiencies in clear research for further benefit from decreasing the blood circulation pressure tolerance in order to mm Hg to possess Koreans. 54 , 55 Depending on the Korean Blood pressure levels Truth Piece 2018, the amount of some body clinically determined to have hypertension increased of step 3 million when you look at the 2002 to eight.nine mil inside the 2016, with only 5.7 billion individuals with compatible and you may persistent antihypertensive procedures within the 2016. 56 The therapy speed improved out-of twenty qeep benzeri uygulamalar two% inside the 1998 so you’re able to 59% inside 2007 also to 61% within the 2016, and also the handle rates enhanced from 5% within the 1998 to 41% inside the 2007 and also to forty two% for the 2016. 56 When you look at the a recent study utilising the Korean Federal Health insurance and Nutrients Test Questionnaire, new incidence out-of blood pressure level plus the amount of adults who require antihypertensive procedures is enhanced, becoming similar along with other places. 55 , 57 , 58 Centered on current degree handling implementation of brand new guidelines inside numerous countries, including the Us, Asia, and you can Korea, this new 2017 ACC/AHA blood pressure direction have a tendency to markedly improve prevalence from blood pressure and what amount of patients who want antihypertensive procedures initiation and people who require cures intensification around the globe. 57 , 58 , 59 , 60 , 61 , 62 Into the a recent study about Federal Health and Nutrients Test Survey, according to the 2017 ACC/AHA rule, compared with new Seventh Combined Federal Committee guideline, this new frequency of blood circulation pressure has increased away from 30.9% in order to 45.6%, the brand new portion of Us grownups suitable for antihypertensive medication has grown off 34.3% so you’re able to 36.2%, and you may 53.4% folks people providing antihypertensive procedures need way more intense decline in its BP. 59 If there is Asia, adoption of your own 2017 ACC/AHA hypertension advice perform lead to the increment regarding prevalence out-of blood pressure levels off twenty-five% in order to fifty%. 63 It must be examined when the such as for instance changes in the fresh symptomatic endurance and you will therapeutic needs regarding so you’re able to mm Hg would raise BP manage as well as associated consequences. Future studies are plus wanted to confirm the newest association anywhere between BP and you may CVD exposure on the younger population that have varied ethnicity and you can to determine in the event your risk/work for proportion to have treatment solutions are positive inside reasonable?chance classification.
Age and you will gender standardization is did utilising the lead method towards the age design of the Korean society, aged 20 so you can 80 ages, in the year 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.