Health and Nutritional Factors Related to Hypertension of Subjects Aged Over 50 in High Income Class - Based on the 2005 Korea National Health and Nutrition Examination Survey -

50세 이상 고소득층 성인 및 노인의 고혈압 관련 건강 및 영양 요인에 관한 연구 - 2005년 국민건강영양조사 결과에 근거하여 -

  • Ahn, So-Hyun (Dept. of Food Science & Nutrition, The Catholic University of Korea) ;
  • Son, Sook-Mee (Dept. of Food Science & Nutrition, The Catholic University of Korea) ;
  • Park, Jin-Kyung (Korea Centers for Disease Control and Prevention, Division of Metabolic Diseases)
  • 안소현 (가톨릭대학교 식품영양학과) ;
  • 손숙미 (가톨릭대학교 식품영양학과) ;
  • 박진경 (질병관리본부 만성병조사과)
  • Received : 2009.05.29
  • Accepted : 2009.07.09
  • Published : 2009.08.02

Abstract

This study was performed to determine the health and nutritional risk factors associated with hypertension in Koreans over the age of 50 in a high-income class (more than twice as much family income as the 2005 Korean minimum cost of living, 668,540 Won). A total of 505 subjects aged over 50 from the 2005 Korean National Health and Nutrition Examination Survey (KNHANES) were divided into two groups: A hypertension group (HG) (N=151, Systolic Blood Pressure ${\geq}$140 mmHg or Diastolic Blood Pressure ${\geq}$90 mmHg) and normal group (NG) (N=354). Subjects who took hypertension medicines or underwent diet therapy were excluded. In HG, mean daily alcohol intake and the amount of alcohol consumption per one occasion were significantly higher than in NG, respectively. A greater number of hypertension subjects answered that they drank alcohol to reduce stress as compared to normal subjects. HG also took fewer dietary supplements than NG. Mean body mass index (BMI), waist circumference, fasting blood sugar level, and 2 hour postprandial blood sugar following a glucose load were significantly higher in HG than in NG, respectively. Also, iron, thiamin, and niacin intakes and the consumption frequency of seaweeds were significantly lower in HG than in NG, respectively. Finally, obesity (BMI ${\geq}$25 $kg/m^2$), abdominal obesity (waist circumference ${\geq}$90 cm for males, ${\geq}$ 80 cm for females), high blood sugar level 2 hours after an oral glucose load (${\geq}$140~200 mg/dl), and hypertriglyceridemia (serum TG ${\geq}$200 mg/dl) were related to a significantly higher risk of hypertension in the subjects (odds ratio: 1.884~3.040). In conclusion, dietary factors such as higher alcohol consumption; lower intakes of iron, thiamin, and niacin; lower consumption frequency of seaweeds; and metabolic syndrome were associated with hypertension in the study subjects.

Keywords

References

  1. Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM, American Heart Association (2006): Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. Hypertension 47(2):296-308 https://doi.org/10.1161/01.HYP.0000202568.01167.B6
  2. Baek JW, Koo BK, Kim KJ, Lee YK, Lee SK, Lee HS (2000): Nutritional status of the long-lived elderly people in Kyungpook Sung-Ju area (I)-Estimation of nutrients intakes. Korean J Nutr 33(4):438-453
  3. Bays HE, Maccubbin D, Meehan AG, Kuznetsova O, Mitchel YB, Paolini JF (2009): Blood pressure-lowering effects of extended-release niacin alone and extended-release niacin/laropiprant combination: a post hoc analysis of a 24-week, placebo- controlled trial in dyslipidemic patients. Clin Ther 31(1):115-122 https://doi.org/10.1016/j.clinthera.2009.01.010
  4. Bowman SA (2009): Socioeconomic characteristics, dietary and lifestyle patterns, and health and weight status of older adults in NHANES, 1999-2002: a comparison of Caucasians and African Americans. J Nutr Elder 28(1):30-46 https://doi.org/10.1080/01639360802633938
  5. Cappuccio FP, Markandu ND, Sagnella GA, MacGregor GA (1985): Sodium restriction lowers high blood pressure through a decreased response of the renin system-direct evidence using saralasin. J Hypertens 3(3):243-247 https://doi.org/10.1097/00004872-198506000-00008
  6. Choi HJ, Jung MH, Kim YS (2004): A study on the relationship between health behavior factors and blood pressure of workers. J Korea Community Health Nursing Academic Society 18(2):312-329
  7. Choi HM, Kim JH, Lee JH, Kim CI, Song KH, Chang KJ, et al. (2006): Nutrition for the 21th century. 2nd ed. Kyo-Moon-Sa. Seoul. pp.203-231
  8. Choi JH, Moon HK (2008): Comparison of dietary patterns by sex and urbanization in different economic status. Korean J Comm Nutr 13(3):346-358
  9. Choi MK, Lee WY, Park JD (2005): Relation among mineral (Ca, P, Fe, Na, K, Zn) intakes, blood pressure, and blood lipids in Korean adults. Korean J Nutr 38(10):827-835
  10. Eom JS, Lee TR, Park SJ, Ahn Y, Chung YJ (2008): The risk factors of the pre-hypertension and hypertension of rural inhabitants in Chungnam-do. Korean J Nutr 41(8):742-753
  11. Ford ES (2004): The metabolic syndrome and mortality from cardiovascular disease and all-causes: findings from the national health and nutrition examination survey II mortality study. Atherosclerosis 173(2):307-312 https://doi.org/10.1016/j.atherosclerosis.2003.12.022
  12. Franklin SS, Khan SA, Wong ND, Larson MG, Levy D (1999): Is pulse pressure useful in predicting risk for coronary heart disease- The Framingham heart study. Circulation 100(4): 354-360 https://doi.org/10.1161/01.CIR.100.4.354
  13. Friedewald WT, Levy RI, Fredrickson DS (1972): Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18(6):499-502
  14. Hajjar IM, Grim CE, George V, Kotchen TA (2001): Impact of diet on blood pressure and age-related changes in blood pressure in the US population: analysis of NHANES III. Arch Intern Med 161(4):589-593 https://doi.org/10.1001/archinte.161.4.589
  15. He FJ, MacGregor GA (2008): Beneficial effects of potassium on human health. Physiol Plant 133(4):725-735 https://doi.org/10.1111/j.1399-3054.2007.01033.x
  16. Hodgson JM, Burke V, Beilin LJ, Puddey IB (2006): Partial substitution of carbohydrate intake with protein intake from lean red meat lowers blood pressure in hypertensive persons. Am J Clin Nutr 83(4):780-787
  17. Huh GY, Son SM (2004): Risk factors of hypertension and development of FFQ and nutrition education program. 2004 Symposium of the Korean Society of Community Nutrition: 109-111
  18. Jetter KM, Cassady DL (2006): The availability and cost of healthier food alternatives. Am J Prev Med 30(1):38-44 https://doi.org/10.1016/j.amepre.2005.08.039
  19. Kamphuis CB, Giskes K, de Bruijn GJ, Wendel-Vos W, Brug J, van Lenthe FJ (2006): Environmental determinants of fruit and vegetable consumption among adults: a systematic review. Br J Nutr 96(4):620-635
  20. Karppanen H, Mervaala E (2006): Sodium intake and hypertension. Prog Cardiovasc Dis 49(2):59-75 https://doi.org/10.1016/j.pcad.2006.07.001
  21. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J (2005): Global burden of hypertension: analysis of worldwide data. Lancet 365(9455):217-223 https://doi.org/10.1016/S0140-6736(05)70151-3
  22. Kim JH, Kim MJ, Kwak HK (2006): Obesity indices and plasma total antioxidant status in hypertensive elderly living in Ulsan area. Korean J Comm Nutr 11(2):279-288
  23. Kim MK, Yun YM, Kim Y (2008): Developing dish-based food frequency questionnaire for the epidemiology study of hypertension among Korean. Korean J Comm Nutr 13(5): 701-712
  24. Kim YI, Kim NI, Won EK, Choi GS (2000): The changes of serum lipid and cardiopulmonary Functions in hypertensive men with obesity. The Korean Journal of Sports Medicine 18(1):92-100
  25. Kim YO (2006): Moderate alcohol consumption does not prevent the hypertension among Korean: the 2001 Korean national health and nutrition examination survey. Korean J Comm Nutr 11(6):707-713
  26. Korea National Statistical Office (2006): Statistics of the aged. Korea National Statistical Office. pp.2-32
  27. Korea National Statistical Office (2007): Annual report of the cause of death statistics (2006). Korea National Statistical Office. pp.15-22
  28. Korean Centers for Disease Control and Prevention (2007a): Korea National Health and Nutrition Examination Survey III (2005) - Depth Analysis(Health Examination). Korea Centers for Diseases Control and Prevention
  29. Korean Centers for Disease Control and Prevention (2007b): Korea National Health and Nutrition Examination Survey III (2005) - Depth Analysis(Nutrition Examination). Korea Centers for Diseases Control and Prevention
  30. Kwak EH, Lee SL, Lee HS, Kwun IS (2003): Relation dietary and urinary Na, K, and Ca level to blood pressure in elderly people in rural area. Korean J Nutr 36(1):75-82
  31. Lawes CM, Vander Hoorn S, Rodgers A (2008): Global burden of blood-pressure-related disease, 2001. Lancet 371(9623): 1513-1518 https://doi.org/10.1016/S0140-6736(08)60655-8
  32. Lee GY, Park MS, Park TJ (2001): Association of hypertension with body mass index in the rural elderly J Korean Acad Fam Med 22(7):1086-1094
  33. Lee HJ, Lee HS, Lee Y, Jang YA, Moon JJ, Kim C (2007): Nutritional environment influences hypertension in the middle- aged Korean adults - Based on 1998 & 2001 National Health and Nutrition Survey. Korean J Comm Nutr 12(3): 272-283
  34. Lee JW, Cho HS (2004): Nutrient intake status of Koreans by income level and age group analyzed from 2001 National Health and Nutrition Survey Data. J Comm Nutr 6(2):67-77
  35. Lee SH, Kim YS, Sunwoo S, Huh BY (2005): A retrospective cohort study on obesity and hypertension risk among Korean adults. J Korean Med Sci 20(2):188-195 https://doi.org/10.3346/jkms.2005.20.2.188
  36. Liu L, Ikeda K, Sullivan DH, Ling W, Yamori Y (2002): Epidemiological evidence of the association between dietary protein intake and blood pressure: a meta-analysis of published data. Hypertens Res 25(5):689-695 https://doi.org/10.1291/hypres.25.689
  37. Ministry of Health and Welfare (2002): 2001 National Health and Nutrition Survey-Chronic disease
  38. Ministry of Health and Welfare & Korea Institute for Health and Social Affairs (2006): The Third Korea National Health and Nutrition Examination Survey (KNHANES III), 2005 -Health Examination-. Ministry of Health and Welfare, Korea Centers for Diseases Control and Prevention
  39. Moon EH (2004). Implementation and evaluation of nutrition education program for hypertensive patients among adults aged 50 and over. Master's degree thesis. Department of Nutrition. The Graduate School of Seoul Women's University. Seoul. pp.35-52
  40. Moon HK, EJ Son (2002): The relationship of nutritional status to the degree of hypertension in residents of Kangbuk-gu, Seoul. Korean J Comm Nutr 7(3):304-315
  41. Moon HK, Park JH (2007): Comparative analysis and evaluation of dietary intake between with and without hypertension using 2001 Korea national health and nutrition examination survey (KNHANES). Korean J Nutr 40(4):347-361
  42. Moreira LB, Fuchs FD, Moraes RS, Bredemeier M, Duncan BB (1998): Alcohol intake and blood pressure: the importance of time elapsed since last drink. J Hypertens 16(2):175-180 https://doi.org/10.1097/00004872-199816020-00007
  43. Nakanishi N, Suzuki K (2005): Daily life activity and the risk of developing hypertension in middle-aged Japanese men. Arch Intern Med 165(2):214-220 https://doi.org/10.1001/archinte.165.2.214
  44. National Institutes of Health. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) NIH Publication No. 04-5230 Available from: http://www.nhlbi. nih.gov/guidelines/hypertension/. Accessed 2004
  45. Niskanen L, Laaksonen DE, Nyyssonen K, Punnonen K, Valkonen VP, Fuentes R, et al. (2004): Inflammation, abdominal obesity, and smoking as predictors of hypertension. Hypertension 44(6): 859-865 https://doi.org/10.1161/01.HYP.0000146691.51307.84
  46. Nord M, Kantor LS (2006): Seasonal variation in food insecurity is associated with heating and cooling costs among low-income elderly Americans. J Nutr 136(11):2939-2944
  47. Oh HS, Chun BY, Kan S, Yeh MH, Kang YS, Kim KY, et al. (2000): The risk factors for the development of hypertension in a rural area- An 1-year prospective cohort study. Korean J Prev Med 33(2):199-207
  48. Park J, Son SM (2003): The dietary behaviors, depression rates and nutrient intakes of the elderly females living alone. Korean J Comm Nutr 8(5):716-725
  49. Park JK, Kim CB, Kim KS, Kang MG, Jee SH (2001): Metaanalysis of hypertension as a risk factor of cerebrovascular disorders in Koreans. J Korean Med Sci 16(1):2-8 https://doi.org/10.3346/jkms.2001.16.1.2
  50. Park SH, Kang YH, Park HY (2008): Alcohol consumption and the coronary heart disease-related risk factors in Korean adults: the Third Korea National Health and Nutrition examination survey (KNHANES III), 2005. Korean J Nutr 41(3):232-241
  51. Pearson JD, Morrell CH, Brant LJ, Landis PK, Fleg JL (1997): Age-associated changes in blood pressure in a longitudinal study of healthy men and women. J Gerontol A Biol Sci Med Sci 52(3):M177-183
  52. Renaud SC, Gueguen R, Conard P, Lanzmann-Petithory D, Orgogozo JM, Henry O (2004): Moderate wine drinkers have lower hypertension-related mortality: a prospective cohort study in French men. Am J Clin Nutr 80(3):621-625
  53. Sesso HD, Chen RS, L'Italien GJ, Lapuerta P, Lee WC, Glynn RJ (2003): Blood pressure lowering and life expectancy based on a Markov model of cardiovascular events. Hypertension 42(5):885-890 https://doi.org/10.1161/01.HYP.0000097602.67134.4D
  54. Shah M, Adams-Huet B, Garg A (2007): Effect of high-carbohydrate or high-cis-monounsaturated fat diets on blood pressure: a meta-analysis of intervention trials. Am J Clin Nutr 85(5):1251-1256
  55. Siervogel RM, Roche AF, Chumlea WC, Morris JG, Webb P, Knittle JL (1982): Blood pressure, body composition, and fat tissue cellularity in adults. Hypertension 4(3):382-386 https://doi.org/10.1161/01.HYP.4.3.382
  56. Son SM, Huh GY (2006): Dietary risk factors associated with hypertension in patients. Korean J Comm Nutr 11(5):661- 672
  57. Son SM, Kim MJ (2001): The effect of nutrition education program for various chronic disease in elderly visiting public health center. J Korean Comm Nutr 6(4):668-677
  58. Son SM, Park YJ, Koo JO, Mo SM, Yoon HY, Sung CJ (1996): Nutritional and health status of Korean elderly from low income, urban area and improving effect of meal service on nutritional and health status - I. Anthropometric measurements and nutrient intakes. Korean J Comm Nutr 1(1):79-88
  59. Song Y, Sesso HD, Manson JE, Cook NR, Buring JE, Liu S (2006): Dietary magnesium intake and risk of incident hypertension among middle-aged and older US women in a 10-year follow-up study. Am J Cardiol 98(12):1616-1621 https://doi.org/10.1016/j.amjcard.2006.07.040
  60. Stamler J, Caggiula A, Grandits GA, Kjelsberg M, Cutler JA (1996): Relationship to blood pressure of combinations of dietary macronutrients. Findings of the Multiple Risk Factor Intervention Trial (MRFIT). Circulation 94(10):2417-2423 https://doi.org/10.1161/01.CIR.94.10.2417
  61. Wang Y, Wang QJ (2004): The prevalence of prehypertension and hypertension among US adults according to the new joint national committee guidelines: new challenges of the old problem. Arch Intern Med 164(19):2126-2134 https://doi.org/10.1001/archinte.164.19.2126
  62. Yim J, Cho M, Yin C, Seo BK, Koh HG, Choue R (2005): Nutrients and salt consumption of hypertension patients according to treatment status. Korean J Nutr 38(9):706-716
  63. Yim KS (2000): Evaluation of the effectiveness of a nutrition education program for hypertensive patients at the community level. Korean J Comm Nutr 5(4):654-661
  64. Yim KS (2008): The effects of a nutrition education program for hypertensive female elderly at the public health center. Korean J Comm Nutr 13(5):640-652
  65. Yim KS, Han MH, Kang YH, Park HR, Kim CH (2000): Analysis of dietary characteristics of participants attending the nutrition education program for hypertensive patients at a public health center. J Korean Diet Assoc 6(2):125-135