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 result away from BP into risk of CVD tends to be toned down that have expanding age as the both incidence from highest BP and you will almost every other CVD exposure factors along with be more common as we age
In the Southern Korea, this new Korean Society out of Blood pressure levels calculated to use the previous blood pressure level standards off systolic BP/diastolic BP ? mm Hg because of insufficient obvious evidence for further make use of reducing the blood circulation pressure tolerance so you can mm Hg to have Koreans. 54 , 55 Depending on the Korean Blood circulation pressure Fact Sheet 2018, how many individuals identified as having blood pressure level enhanced away from step three million in the 2002 to 8.9 mil for the 2016, with only 5.eight mil people with suitable and you may persistent antihypertensive medication inside the 2016. 56 The therapy rate enhanced away from twenty-two% in 1998 so you can 59% for the 2007 also to 61% when you look at the 2016, while the manage rate increased off 5% within the 1998 so you’re able to 41% within the 2007 also to 44% in 2016. 56 Into the a recent study utilizing the Korean Federal Health insurance and Diet Test Questionnaire, new frequency away from blood circulation pressure together with quantity of adults who want antihypertensive medication might be enhanced, being similar together with other nations. 55 , 57 , 58 According to previous studies dealing with implementation of the fresh advice during the several places, including the Us, Asia, and you can Korea, the brand new 2017 ACC/AHA blood pressure level direction will markedly improve frequency out of hypertension and you can just how many clients who require antihypertensive therapy initiation and the ones who are in need of medication intensification global. 57 , 58 , 59 , sixty , 61 , 62 When you look at the a recent study throughout the Federal Health insurance and Nutrients Test Questionnaire, according to 2017 ACC/AHA tip, compared with the fresh Seventh Joint National Committee rule, the latest prevalence of blood pressure has grown from 31.9% in order to 45.6%, new percentage of Us adults suitable for antihypertensive treatment has increased from 34.3% so you can 36.2%, and you will 53.4% people grownups bringing antihypertensive cures you desire way more extreme reduction in the BP. 59 In case of China, use of your 2017 ACC/AHA blood pressure guidance perform resulted in increment throughout the prevalence out-of blood circulation pressure away from sdc çevrimiçi twenty five% so you can fifty%. 63 It should be evaluated in the event that eg alterations in the fresh diagnostic endurance and you can therapeutic goals from in order to mm Hg manage boost BP handle and its own relevant benefit. Future research is as well as had a need to confirm brand new relationship between BP and you may CVD exposure regarding the younger people having varied ethnicity and you may to choose in the event your risk/benefit proportion to have treatment is favorable within low?risk category.
The age and you can sex standardization is did with the head means towards the age build of your Korean population, old 20 to help you 80 ages, around 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.