This process may lead to a good misclassification away from BP kinds and you may present dilution bias, possibly underestimating genuine connections
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 out-of BP on the threat of CVD can be toned down with increasing ages because the the prevalence from large BP and you will other CVD chance things along with be more common with age
For the South Korea, the fresh Korean People regarding Blood pressure calculated to make use of the prior blood pressure level criteria away from systolic BP/diastolic BP ? mm Hg because of too little obvious evidence for further make the most of lowering the blood pressure levels tolerance so you can mm Hg getting Koreans. 54 , 55 With regards to the Korean Blood pressure level Reality Piece 2018, the number of some body identified as having hypertension increased of 3 billion within the 2002 to 8.nine million during the 2016, with just 5.seven mil individuals with compatible and chronic antihypertensive cures into the 2016. 56 The procedure price enhanced out-of twenty two% when you look at the 1998 to help you 59% within the 2007 and 61% for the 2016, as well as the handle rate enhanced out-of 5% during the 1998 to help you 41% into the 2007 and to forty two% in 2016. 56 In the research conducted recently by using the Korean National Health and Nutrition Test Survey, the fresh new incidence regarding blood pressure level and number of people who require antihypertensive medication was enhanced, are comparable along with other nations. 55 , 57 , 58 Centered on latest education dealing with utilization of this new advice within the numerous places, such as the United states, Asia, and you will Korea, the newest 2017 ACC/AHA blood circulation pressure guidelines tend to markedly increase the incidence of blood pressure and you may how many customers who need antihypertensive the adult hub review treatment initiation and the ones who need therapy intensification all over the world. 57 , 58 , 59 , sixty , 61 , 62 In research conducted recently about Federal Health insurance and Diet Test Survey, according to the 2017 ACC/AHA tip, compared with the fresh new 7th Joint National Committee guideline, the new incidence off blood circulation pressure has increased away from 29.9% to help you forty five.6%, the part of All of us people suitable for antihypertensive therapy has increased off 34.3% to 36.2%, and you will 53.4% people adults taking antihypertensive therapy you desire far more extreme reduction in its BP. 59 If there is Asia, adoption of 2017 ACC/AHA blood circulation pressure guidance manage resulted in increment on prevalence from hypertension regarding 25% in order to fifty%. 63 It ought to be evaluated in the event the such as for instance alterations in the latest symptomatic threshold and therapeutic needs out of to mm Hg create boost BP handle and its related lead. Coming scientific studies are plus needed seriously to show this new organization anywhere between BP and CVD exposure about more youthful inhabitants that have varied ethnicity and you can to decide in case your risk/work for ratio for treatment is good in this lower?chance classification.
The age and you can gender standardization are performed utilising the direct means into years design of your Korean populace, old 20 so you’re able to 80 many years, in 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.