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January 1, 2023Global HeartOpen Access

Current Status of Cardiovascular Disease According to the Duration of Hypertension in Korean Adults

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Key result

Achieving a target blood pressure below 140/90 mmHg in hypertensive adults significantly reduced the adjusted risk of stroke (HR 0.628) compared to not achieving the target.

Why the study?

Hypertension is a crucial factor in cardiovascular and cerebrovascular diseases, and this study investigated its prevalence, management, and correlation with CVD and stroke risk in Korean adults.

Does achieving target blood pressure reduce the risk of cardiovascular disease and stroke in Korean adults with hypertension?

Population

61,379 subjects representing Korea's population of 49,068,178 subjects

Comparison

Duration of hypertension and blood pressure control status

Design

Retrospective cross-sectional study

Authors

BCByoung Geol ChoiJKJung Boone KimSRSeung‐Woon Rha

Discussion

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Overview

May support BP target achievement to lower stroke risk in Korean hypertensives; leaves open causal confirmation in prospective trials.

Key Points

  • To assess the prevalence and control of hypertension in Korean adults and evaluate how hypertension duration and blood pressure management influence the risk of cardiovascular disease and stroke.
  • Conducted a retrospective cross-sectional analysis using the representative Korean National Health and Nutritional Examination Survey (KNHANES) database (N=61,379).
  • Assessed blood pressure control targets (<140/90 mmHg) and measured the prevalence of cardiovascular disease, myocardial infarction, and stroke across duration of hypertension.
  • The overall prevalence of hypertension was 25.7% (representing 9,965,618 individuals) and increased steeply with advancing age.
  • Cardiovascular risks escalated with disease duration; individuals with hypertension lasting longer than 20 years had a prevalence of 14.6% for ischemic heart disease, 5.0% for myocardial infarction, and 12.2% for stroke.
  • Reaching the target blood pressure goal below 140/90 mmHg reduced the risk of all cardiovascular diseases and stroke by nearly half, though fewer than two-thirds of hypertensive individuals achieved this target.

Study Design

Type

Cross-Sectional (n=45,811)

Structured PICO

Does achieving target blood pressure reduce the risk of cardiovascular disease and stroke in Korean adults with hypertension?

P
Population
45,811 Korean adults aged 18-80 years from the KNHANES database were evaluated to assess the prevalence of hypertension and the impact of blood pressure control on cardiovascular disease.
E
Exposure
Achievement of target blood pressure (<140/90 mmHg, or <130/80 mmHg for patients with diabetes or chronic kidney disease) and duration of hypertension.
C
Comparator
Non-hypertensive individuals, or hypertensive individuals who did not achieve target blood pressure.
O
Outcome
Prevalence and risk of cardiovascular disease (ischemic heart disease, myocardial infarction, angina pectoris) and stroke.hard clinical

Main Result

Hazard Ratio: 0.628 (95% CI 0.622–0.634)

Absolute Event Rate: 2.3% vs 5.5%

p-value: p=<0.001

In Korean adults, longer duration of hypertension is associated with increased cardiovascular risk, but achieving target blood pressure reduces the risk of cardiovascular disease and stroke by nearly half.

Limitations

  • Cross-sectional design cannot determine causality
  • Only survivors were included, potentially introducing survival bias
  • Risk of death from disease was not assessed
  • Lifestyle modifications were not assessed
  • Potential unmeasured confounders such as statin and antiplatelet therapy
  • Cross-sectional study design cannot conclude causality
  • Only survivors were included at the time of the investigation
  • Lifestyle modification was not assessed
  • Other pharmacotherapy, including statin and antiplatelet therapy, was not assessed
  • Optimal target blood pressure definition is controversial

Cite This Study

Choi et al. (2023) conducted a cross-sectional in Hypertension (n=45,811). Achieving target blood pressure (<140/90 mmHg) vs. Not achieving target blood pressure was evaluated on Stroke (HR 0.628, 95% CI 0.622-0.634, p=<0.001). Achieving a target blood pressure below 140/90 mmHg in hypertensive adults significantly reduced the adjusted risk of stroke (HR 0.628) compared to not achieving the target.

synapsesocial.com/papers/6a1f438fd03d2b72e7233cb2https://doi.org/10.5334/gh.1201
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prevalence and management of hypertension in Korean adults2022 · 3 citations
  2. 2Prevalence, Awareness, Treatment, and Control of Hypertension in Korea2019 · 78 citations
  3. 3Korea Hypertension Fact Sheet 2023: analysis of nationwide population-based data with a particular focus on hypertension in special populations2024 · 59 citations
  4. 4Korea hypertension fact sheet 20182018 · 144 citations
  5. 5Prevalence of prehypertension and hypertension in a Korean population: Korean National Health and Nutrition Survey 20012006 · 174 citations