This method can lead to a good misclassification of BP categories and present dilution prejudice, perhaps underestimating genuine relationships

This method can lead to a good misclassification of BP categories and present dilution prejudice, perhaps underestimating genuine relationships

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 from BP to the chance of CVD tends to be diluted which have growing many years given that both the frequency away from large BP and almost every other CVD exposure points together with become more prevalent as we grow older

From inside the South Korea, the newest Korean Society regarding Hypertension computed to use the last blood pressure conditions regarding systolic BP/diastolic BP ? mm Hg due to insufficient obvious proof for further make use of reducing the hypertension threshold so you can mm Hg for Koreans. 54 , 55 Depending on the Korean Blood pressure level Facts Sheet 2018, exactly how many anybody clinically determined to have blood pressure levels improved out of step 3 billion when you look at the 2002 to 8.nine billion when you look at the 2016, with only million individuals with suitable and you may persistent antihypertensive treatment in the 2016. 56 The procedure rate enhanced out-of 22% from inside the 1998 so you’re able to 59% from inside the 2007 and also to 61% inside 2016, together with manage speed increased off 5% in 1998 so you’re able to 41% into the 2007 and also to 44% from inside the 2016. 56 From inside the a recent study with the Korean National Health insurance and Diet Examination Questionnaire, this new prevalence regarding hypertension together with amount of people who are in need of antihypertensive treatment might possibly be increased, becoming comparable with other places. 55 , 57 , 58 Considering present degree approaching utilization of the latest assistance from inside the numerous countries, such as the All of us, Asia, and you may Korea, the brand new 2017 ACC/AHA blood pressure assistance tend to significantly help the prevalence from blood circulation pressure and you can what number of customers who need antihypertensive cures initiation and the ones who want treatment intensification in the world. 57 , 58 , 59 , sixty , 61 , 62 Into the research conducted recently throughout the National Health insurance and Diet Test Questionnaire, depending on the 2017 ACC/AHA rule, compared to new 7th Joint Federal Panel rule, the new frequency from blood pressure level has increased from 31.9% in order to forty-five.6%, this new part of All of us grownups suitable for antihypertensive therapy has increased out of 34.3% so you’re able to 36.2%, and you will 53.4% of us people taking antihypertensive medication you need far more intense reduction in their BP. 59 In case of Asia, use of 2017 ACC/AHA hypertension recommendations manage resulted in increment about frequency off blood circulation pressure from twenty five% in order to 50%. 63 It must be evaluated if the including changes in the newest diagnostic tolerance and you may therapeutic objectives off so you’re able to mm Hg perform boost BP manage and its own related lead. Coming scientific studies are plus needed to prove new relationship anywhere between BP and you will CVD risk regarding younger inhabitants that have varied ethnicity and to determine whether your exposure/benefit proportion having treatment solutions are advantageous within this lowest?exposure classification.

This and you will gender standardization was performed making use of the direct approach towards the ages structure of your own Korean populace, aged 20 in order 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.