Journal of Life Science (생명과학회지)

Korean Society of Life Science (한국생명과학회)
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The Age-Related Trend in Blood Pressure and the Prevalence of Hypertension in Korean Adults

한국 성인의 연령에 따른 혈압변화 양상과 고혈압 유병률

  • Lee, Dae-Taek (Kim Chang Kew Exercise Physiology Laboratory, Kookmin University) ;
  • Lee, Yong-Soo (Kim Chang Kew Exercise Physiology Laboratory, Kookmin University)
  • 이대택 (국민대학교 체육대학 운동생리학실험실) ;
  • 이용수 (국민대학교 체육대학 운동생리학실험실)
  • Received : 2011.05.10
  • Accepted : 2012.02.06
  • Published : 2012.02.28
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Abstract

A cross-sectional analysis of blood pressure (BP) changes and the current prevalence and distribution of hypertension among age groups in Korea were conducted. Systolic (SBP), diastolic (DBP), and pulse (PP) pressures were evaluated. Residents visiting a local Community Health Center for a health check-up and/or participating in the Health Promotion Program were included for the analyses. A total of 6,570 subjects (2,809 men, 3,761 women) were divided into five age groups: 30-39, 40-49, 50-59, 60-69, and $70\leq$ years. Comparisons were made between sex and among age groups. SBP and DBP were continuously elevated, while men showed higher levels than women until their mid-60s; then, the trend was reversed. DBP in men became elevated from their 30s, reaching the highest in the 40s then slowly decreasing. DBP in women increased up to their 40s and 50s, then reached a plateau. PP increased rapidly from the 50s in both sexes. The major contributor of age-related BP elevation may be large artery stiffness in men, particularly from their 50s, while the blood pressure elevation of women may relate to diverse factors including large artery stiffness, stroke volume, and ventricular ejection rate. The rapid elevation of PP after the 50s in both men and women could represent a risk of cardiovascular or coronary mortality, particularly with increasing age. The current data showed a higher rate of hypertension in both sexes compared to previous reports. When those with both high-normal BP and hypertension are looked at in combination, BP management of the target population should be drastically elevated.

한국인의 연령에 따른 혈압변화와 고혈압 유병률 그리고 수축기(SBP)와 이완기(DBP)혈압 및 맥압(PP)의 변화양상을 횡단적으로 평가하였다. 지역보건소 건강검진 및 건강증진프로그램을 통해 진료된 대상자 6,570명(남2,809, 여 3,761)을 5 연령군(30, 40, 50, 60대 그리고 70세 이상)으로 구분하여 비교 분석하였다. SBP는 지속적으로 증가하였으며, 남자가 여자에 비해 높게 유지되었다. 그러나 60대 중반에서 역전되었다. DBP는 남자 30대부터 증가하여 40대에서 최고점을 이르렀다가 하강하였다. 여자는 4-50대까지 증가하다가 일정한 수준을 유지하였다. 남녀 모두에서 PP는 50대 이후 가파르게 증가하였다. 남자의 경우 특히 50대 이후의 연령과 관계한 혈압의 증가는 큰동맥의 굳어짐 현상이 가장 큰 공헌을 하는 것으로 보이며, 여성의 경우는 큰동맥굳어짐, 일회심박출량 또는 심실박출율과 같은 다양한 원인에 기인하는 것으로 평가된다. PP의 증가는 심장에 부담을 주게 되며 특히 50대 이후 남녀 모두에서 가파른 위험성이 예견된다. 이 연구에서는 남녀 모두에서 고혈압 발병률이 이전의 연구들에 비해 높게 나타나고 있다. 높은정상혈압을 고혈압 위험군에 포함시킨다면 고혈압 관리를 위한 대상자의 범위는 상당히 확장될 것으로 보인다.

Keywords

References

  1. Anderson, K. M., P. W. F. Wilson, P. M. Odell, and W. B. Kannel. 1991. An updated coronary risk profile. A statement for health professionals. Circulation 83, 356-362. https://doi.org/10.1161/01.CIR.83.1.356
  2. Benetos, A., A. Rudnichi, M. Safar, and L. Guize. 1998. Pulse pressure and cardiovascular mortality in normotensive and hypertensive subjects. Hypertension 32, 560-564. https://doi.org/10.1161/01.HYP.32.3.560
  3. Berne, R. M. and M. N. Levy. 1992. Cardiovascular Physiology. pp. 113-144, CV Mosby Company. St Louis, Missouri.
  4. Black, H. R. 2004. The paradigm has shifted to systolic blood pressure. J. Hum. Hypertension 18, S3-S7. https://doi.org/10.1038/sj.jhh.1001795
  5. Burt, V. L., P. Whelton, E. J. Roccella, C. Brown, J. A. Cutler, M. Higgins, M. J. Horan, and D. Labarthe. 1995. Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988-1991. Hypertension 25, 305-313. https://doi.org/10.1161/01.HYP.25.3.305
  6. Carson, A. P., G. Howard, G. L. Burke, S. Shea, E. B. Levitan, and P. Muntner. 2011. Ethnic differences in hypertension incidence among middle-aged and older adults: The multi-ethnic study of atherosclerosis. Hypertension 57, 1101-1107. https://doi.org/10.1161/HYPERTENSIONAHA.110.168005
  7. Chobanian, A. V., G. L. Bakris, H. R. Black, W. C. Cushman, L. A. Green, J. L. Izzo Jr., D. W. Jones, B. J. Materson, S. Oparil, J. T. Wright Jr., and E. J. Roccella. 2003. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 289, 2560-2572. https://doi.org/10.1001/jama.289.19.2560
  8. Conen, D., P. M. Ridker, J. E. Buring, and R. J. Glynn. 2007. Risk of cardiovascular events among women with high normal blood pressure or blood pressure progression: prospective cohort study. Br. Med. J. 335, 432-440. https://doi.org/10.1136/bmj.39269.672188.AE
  9. Fang, J., S. Madhavan, H. Cohen, and M. H. Alderman. 1995. Measures of blood pressure and myocardial infarction in treated hypertensive patients. J. Hypertens 13, 413-419.
  10. Franklin, S. S., W. G. Gustin, N. D. Wong, M. G. Larson, M. A. Weber, W. B. Kannel, and D. Levy. 1997. Hemodynamic patterns of age-related changes in blood pressure: the Framingham Heart Study. Circulation 96, 308-315. https://doi.org/10.1161/01.CIR.96.1.308
  11. Franklin, S. S., S. A. Khan, N. D. Wong, M. G. Larson, and D. Levy. 1999. Is pulse pressure useful in predicting risk for coronary heart Disease? The Framingham heart study. Circulation 100, 354-360. https://doi.org/10.1161/01.CIR.100.4.354
  12. Gasowski, J. R. H. Fagard, J. A. Staessen, T. Grodzicki, S. Pocock, F. Boutitie, F. Gueyffier, and J. P. Boissel. 2002. Pulsatile blood pressure component as predictor of mortality in hypertension: a meta-analysis of clinical trial control groups. J. Hypertens 20, 145-151. https://doi.org/10.1097/00004872-200201000-00021
  13. Kannel, W. B. 1996. Blood pressure as a cardiovascular risk factor: prevention and treatment. JAMA 275, 1571-1576. https://doi.org/10.1001/jama.1996.03530440051036
  14. Kannel, W. B., P. A. Wolf, D. L. McGee, T. R. Dawber, P. McNamara, and W. P. Castelli. 1981. Systolic blood pressure, arterial rigidity, and risk of stroke. JAMA 245, 1225-1229. https://doi.org/10.1001/jama.1981.03310370017013
  15. Kelly, R., R. Tunin, and D. Kass. 1992. Effect of reduced aortic compliance on left ventricular contractile function and energetics in vivo. Circ. Res. 71, 490-502. https://doi.org/10.1161/01.RES.71.3.490
  16. Kim, S. J., J. Lee, C. M. Nam, S. H. Jee, I. S. Park, K. J. Lee, and S. Y. Lee. 2010. Progression rate from new-onset pre-hypertension to hypertension in Korean adults. Circ. J. 75, 135-140. https://doi.org/10.1253/circj.CJ-09-0948
  17. Kobalava, A. D., Y. V. Kotovskaya, L. A. Babaeva, and V. S. Moiseev. 2006. Validation of TM-2655 oscillometric device for blood pressure measurement. Blood Press. Monit. 11, 87-90. https://doi.org/10.1097/01.mbp.0000200484.49540.12
  18. Korea National Health Statistics 2009, 2010. pp. 54, Ministry of Health and Welfare, Korea
  19. Kramer, H., C. Han, W. Post, D. Goff, A. Diez-Roux, R. Cooper, S. Jinagouda, and S. Shea. 2004. Racial/ethnic differences in hypertension and hypertension treatment and control in the multi-ethnic study of atherosclerosis (MESA). Am. J. Hypertens 17, 963-970. https://doi.org/10.1016/j.amjhyper.2004.06.001
  20. Lewington, S., R. Clarke, N. Qizilbash, R. Peto, and R. Collins. 2002. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 360, 1903-1913. https://doi.org/10.1016/S0140-6736(02)11911-8
  21. Madhavan, S., W. L. Ooi, H. Cohen, and M. H. Alderman. 1994. Relation of pulse pressure and blood pressure reduction to the incidence of myocardial infarction. Hypertension 23, 395-401. https://doi.org/10.1161/01.HYP.23.3.395
  22. Nichols, W. W., F. A. Nicolini, and C. J. Pepine. 1992. Determinants of isolated systolic hypertension in the elderly. J. Hypertens 10, S73-S77.
  23. Pannier, B., P. Brunel, W. El Aroussy, P. Lacolley, and M. E. Safar. 1989. Pulse pressure and echocardiographic findings in essential hypertension. J. Hypertens 7, 127-129.
  24. Safar, M. E. 1989. Pulse pressure in essential hypertension: clinical and therapeutical implications. J. Hypertens 7, 769-776. https://doi.org/10.1097/00004872-198910000-00001
  25. Sagie, A., M. G. Larson, and D. Levy. 1993. The natural history of borderline isolated systolic hypertension. N. Engl. J. Med. 329, 1912-1917. https://doi.org/10.1056/NEJM199312233292602
  26. Vasan, R. S., M. G. Larson, E. P. Leip, J. C. Evans, C. J. O'Donnell, W. B. Kannel, and D. Levy. 2001. Impact of high-normal blood pressure on the risk of cardiovascular disease. N. Engl. J. Med. 345, 1291-1297. https://doi.org/10.1056/NEJMoa003417
  27. Vasan, R. S., A. Beiser, S. Seshadri, M. G. Larson, W. B. Kannel, R. B. D'Agostino, and D. Levy. 2002. Residual lifetime risk for developing hypertension in middle-aged women and men: The Framingham Heart Study. JAMA 287, 1003-1010. https://doi.org/10.1001/jama.287.8.1003
  28. Watanabe, H., S. Ohtsuka, M. Kakihana, and Y. Sugishita. 1993. Coronary circulation in dogs with experimental decrease in aortic compliance. J. Am. Coll. Cardiol. 21, 1497-1506. https://doi.org/10.1016/0735-1097(93)90330-4
  29. Zhang, H., L. Thijs, T. Kuznetsova, R. H. Fagard, X. Li, and J. A. Staessen. 2006. Progression to hypertension in the non-hypertensive participants in the Flemish Study on Environment, Genes and Health Outcomes. J. Hypertens 24, 1719-1727. https://doi.org/10.1097/01.hjh.0000242395.07473.92

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