• Korean Journal of Clinical Pharmacy
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• v.12 no.1
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• pp.29-38
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• 2002

Hypertension is an important public health problem because it increases the risk of stroke, angina, myocardial infarction, heart failure, and end-stage renal disease. If it is not actively treated, morbidity and mortality increase with hypertension-induced complications and quality of life decreases. This study was to evaluate the use of antihypertensive drugs and blood pressure changes and to compare algorithms chosen (or the 1st and 2nd line therapy of hypertension based on the JNC VI recommendations. The medical charts of 222 patients with essential hypertension at St. Vincent's Hospital in Suwon from January 1997 to January 2000 were reviewed retrospectively. Data collection and analysis included baseline BP underlying diseases and complications, administered antihypertensives, BP changes, changes of antihypertensive regimen, and adverse effects with treatments. As results, the higher BP the patients had, the more frequent they had target organ damages and clinical cardiovascular diseases. Mean duration to reduce blood pressure less than 140/90 mmHg was 8 weeks in $85.3\%$ of the patients. The rate of control in BP was $82.4\%$ at 6 months. The major antihypertensive drugs prescribed were calcium channel blockers $(61.8\%)$ , ACE inhibitors $(19.1\%),\;\beta-blockers\;(13.7\%)$ and diuretics $(5.3\%)$ as the 1st-line monotherapy. The methods of treatment used as the 1st-line therapy were monotherapy$(59\%)$ and combination therapy $(41\%)$. Blood pressure change was significantly greater for combination therapy than monotherapy$(-26.2\pm21.4\;vs.\;-18.56\pm16.7$ mmHg for systolic blood pressure; P<0.003, $-16.9\pm13.2\;vs.\;-9.2\pm12.8$ mmHg for diastolic blood pressure; p<0.001). When blood pressure was not completely controlled with the first antihypertensive selected, the 2nd line therapy had 4 options: addition of 2nd agent from different class; $66.2\%$, substitution with another drug, $21.9\%$ increase dose $11.9\%$ continue first regimen $27.9\%$ Calcium channel blockers were the most frequently prescribed agents. This was not comparable to the JNC VI guideline which recommended diuretics and $\beta-blockers$ for the 1st-line therapy. Most of patients achieved the goal BP and maintained it until 6 months, but the remaining patients should be controlled more tightly to improve their BP with combination of life style modification, patient education, and pharmacotherapy.

• Journal of Preventive Medicine and Public Health
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• v.34 no.4
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• pp.437-443
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• 2001

Objectives : This study was peformed to assess the association between the social support and blood pressure(BP) in a rural community. Methods : A cross-sectional survey, comprising a health examination including BP, height and weight and a questionnaire-based interview which investigated social support, demographic factors, smoking, drinking, and etc. was peformed between February 10th and March 5th, 1998. The survey included 318 persons who were over than 30-year-old in the rural community of Kwangju, Republic of Korea. We excluded persons who taking antihypertensive medications or who provided incomplete information; we subsequently analyzed the data from 284 persons. In order to test the hypothesis of an association between BP and social support controlling confounders such as age, educational level, working time, body mass index, smoking and drinking, the data was analyzed using multiple linear regression analysis. Results : The subjects were composed of 109(38.4%) males and 175(61.6%) females with mean ages of 62.0 years and 61.1 years, respectively. The hypertension prevalence was 41.3% among males and 45.1% among females. In the correlation analysis, higher total social support scores correlated significantly with lower systolic BP in both males and females. The hypertension prevalence increased significantly with the decreasing of the social support in males. In multiple regression analysis, systolic and diastolic blood pressure showed a negative association with social support in both males and females, although this was not statistically significant. Conclusions : Larger and broader studies are required in the future in order to identify the association between the social support and BP.

• Journal of Korean Neurosurgical Society
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• v.54 no.3
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• pp.159-163
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• 2013

Objective : Cerebral hyperperfusion syndrome (CHS) is a serious complication after carotid endarterectomy (CEA). However, the prevalence of CHS has decreased as techniques have improved. This study evaluates the role of strict blood pressure (BP) control for the prevention of CHS. Methods : All 18 patients who received CEA from February 2009 through November 2012 were retrospectively reviewed. All patients were routinely managed in an intensive care unit by a same protocol. The cerebral perfusion state was evaluated on the basis of the regional cerebral blood flow (rCBF) study by perfusion computed tomography (pCT) and mean velocity by transcranial doppler (TCD). BP was strictly controlled (<140/90 mm Hg) for 7 days. When either post-CEA hyperperfusion (>100% increase in the rCBF by pCT or in the mean velocity by TCD compared with preoperative values) or CHS was detected, BP was maintained below 120/80 mm Hg. Results : TCD and pCT data on the patients were analyzed. Ipsilateral rCBF was significantly increased after CEA in the pCT (p=0.049). Post-CEA hyperperfusion was observed in 3 patients (18.7%) in the pCT and 2 patients (12.5%) in the TCD study. No patients developed clinical CHS for one month after CEA. Furthermore, no patients developed additional neurological deficits related to postoperative cerebrovascular complications. Conclusion : Intensive care with strict BP control (<140/90 mm Hg) achieved a low prevalence of post-CEA hyperperfusion and prevented CHS. This study suggests that intensive care with strict BP control can prevent the prevalence of post-CEA CHS.

• Journal of Nutrition and Health
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• v.37 no.6
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• pp.455-463
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• 2004

Flavonoids contained in grapes are potent antioxidants that may protect against oxidative stress and reduce the risk of chronic diseases related with free radical damage. In this study we investigated the effect of daily grape juice supplementation on blood pressure (BP), plasma lipid profiles and the generation of free radicals in 67 healthy volunteers (29 smoker, 38 nonsmokers). The daily 480 ml of grape juice supplementation for 8 weeks resulted in a significant decrease in diastolic BP by 6.5％ in smokers and systolic and diastolic BP by 11.2 and 3.7％ in non-smokers. Plasma total cholesterol, HDL- and LDL-cholesterollevels in smokers and total cholesterol in non-smokers were significantly increased after the intervention. Plasma triglycerides and conjugated dienes were not affected by grape juice supplementation. Levels of free radical determined by reading the lucigenin-perborate ROS generating sources, decreased significantly by 18％ compared to the beginning of the study. The results indicated that the consumption of grape juice may reduce BP and free radical generation in smokers, which was possibly exerted by flavonoids. Our findings suggested that the grape juice has protective effect on chronic disease due to the overproduction of free radical in smokers.

• Journal of the Korean Society of School Health
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• v.17 no.1
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• pp.55-69
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• 2004

Purpose ： To describe epidemiological characteristics and related factors in school personnel with hypertension. Method ： 5,384 school personnel (2,638 males and 2,746 females) received physical examination at the Seoul School Health Center in 2002. blood pressure(BP) was classified by JNC 7th report. Normal BP is systolic BP <120 and diastolic BP<80, prehypertension BP is 120-139 or 80-89mmHg, stage 1 hypertension BP is 140-159 or 90-99, and stage 2 hypertension >=160 or >=100 mmHg. each group was evaluated by gender. We used multiple regression and logistic regression. Results ： Normotension was 20.13% in males and 48.65% in female, prehypertension 43.4% in males and 38.06% in females, stage 1 hypertension 26.38% in males and 10.99% in females, stage2 hypertension 9.59% in males and 3.2% in females. the older age group had higher distribution of stage 1 hypertension and stage 2 hypertension. The means and abnormal rates of BMI, blood sugar, total cholesterol, GOT, GPT, and GTP was higher when their blood pressure was higher. However, an alcohol habit among lifestyle factors had an inverse effect. Higher Bp was correlated to a higher BMI, FBS, and cholesterol-like dose response. In stage 1 hypertension, the related factors of hypertension for males were BMI, amount of cigarettes smoked, exercise, blood sugar, total cholesterol, and GTP. In stage 1 hypertension, age, BMI, exercise, blood sugar, total cholesterol were related factors in female. In stage 2 hypertension, age and smoking were related factors in male, and age, BMI, and cholesterol in female. Conclusions ： It is possible to intervene in all related factors of hypertension except age through life-style modification and appropriate medical management. Active health promotion is needed in School personnel.

• Korean Journal of Clinical Laboratory Science
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• v.46 no.3
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• pp.106-110
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• 2014

Obstructive sleep apnea-hypopnea (OSAH) is known to be related to nocturnal blood pressure (BP) and hypertension. The aim of this study was to evaluate the prevalence of hypertension according to the apnea-hypopnea grading. A total of 2,210 adults with snoring and obstructive sleep apnea were referred to our sleep center from July 2009 to May 2013. Clinical blood pressure (BP) was measured before sleeping (bedtime BP) and immediately after waking up in the next morning (morning BP). Subjects were classified into four groups based on the apnea-hypopnea index (AHI) from PSG as follows: control group (n=470) simple snoring and with AHI<5; mild group (n=577) with $AHI{\geq}5$ and <15; moderate group (n=508) $AHI{\geq}15$ and <30; and severe group (n=655) with $AHI{\geq}30$. The differences and correlations between BP and PSG parameters according to the AHI groups were analyzed. Patient's were classified as nomentensive (blood pressure <120/90 mmHg, n=700), prehypertensive (blood pressure < $140-120{\leq}mmHg$, n=1297) hypertensive (blood pressure ${\geq}140/90mmHg$, n=214) according to the office blood pressure measurements. The comparison of sleep parameters showed that OSA groups had a significantly higher stage N1 (control group vs. moderate OSA, severe OSA; $66.4{\pm}30.7$ vs. $85.5{\pm}36.6$, $128.4{\pm}57.3$, p<0.001) and total arousal number (control vs. moderate OSA, severe OSA; $110.7{\pm}47.7$ vs. $150.8{\pm}56.6$, $236.6{\pm}95.8$, p<0.001) compared to control group. The comparison of sleep parameters showed that OSA groups had a significantly lower stage N2 (control group vs. moderate OSA, severe OSA; $172.6{\pm}47.2$ vs. $150.7{\pm}50.5$, $120.3{\pm}57.4$, p<0.001), stage N3 (control group vs. moderate OSA, severe OSA; $38.4{\pm}33.4$ vs. $27.4{\pm}26.0$, $56.1{\pm}27.5$, p<0.001), REM (control group vs. moderate OSA, severe OSA; $64.3{\pm}25.5$ vs. $56.1{\pm}27.5$, $47.3{\pm}25.9$, p<0.001) and mean SaO2% (control group vs. moderate OSA, severe OSA; $90.0{\pm}3.5$ vs. $82.5{\pm}5.5$, $70.0{\pm}8.8$, p<0.001) compared to control group. The Apnea-hypopnea index was significantly higher in OSA groups, increased systolic and diastolic blood pressure than in the nomentensive group (bed time systolic pressure vs. AHI; <120 vs. 120-139, 140-159, >159; $17.5{\pm}18.6$ vs. $24.9{\pm}21.0$, $31.0{\pm}25.7$, $42.3{\pm}31.7$, p<0.001), (bed time diastolic pressure vs. AHI; 60-79 vs. 80-89, 90-99, >99; $19.3{\pm}19.7$ vs. $22.4{\pm}20.3$, $29.8{\pm}23.3$, $38.8{\pm}28.5$, p<0.001). AHI was positively correlated with morning systolic pressure, diastolic pressure, bed time systolic pressure and diastolic pressure (r=0.314, 0.279, 0.233 and 0.200, respectively, p<0.001). We conclude that BMI, Age, neck circumference and AHI increase with the blood pressure.

• Journal of the Institute of Convergence Signal Processing
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• v.22 no.2
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• pp.51-56
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• 2021

The brachial systolic blood pressure and pulse pressure are the predictors of cardiovascular disease in individuals over 50 years of age. As the stiffness increases, the reflex amplitude and pressure in the late systole increase, resulting in an increase in left ventricular load and myocardial oxygen demand. Therefore, it is necessary to study how stiffness affects blood pressure. In this study, the blood pressure pulse waves were measured before and after taking the drug, and the blood pressure pulse wave was measured before and after myocardial heart transplantation in patients with heart failure. The correlation between R, L, and C components of the Windkessel model was estimated by increasing blood pressure. As a result of modeling the parameters of the Windkessel model using the curve fitting method, the increase in blood pressure and decrease in systolic rise time were due to the increase in the L component in the RLC Windkessel model. Among the various mechanical characteristics of blood vessels, the most important parameter affecting high BP waveform is the inertance.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.16 no.1
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• pp.173-187
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• 2022

Recent studies have focused on self-management of hypertension using smart devices (cellular phones, tablets, watches). It has proven to be an effective tool for early detection and control of high Blood Pressure (BP) without affecting patients' daily routines. This systematic review surveys the existing self-monitoring systems, evaluate their effectiveness and compares the different approaches. We investigated the current systems in terms of various attributes, including methods used, sample size, type of investigation, inputs/ outputs, rate of success in controlling BP, group of users with higher response rate and beneficiaries, acceptability, and adherence to the system. We identified some limitations, shortcomings, and gaps in the research conducted recently studying the impact of mobile technology on managing hypertension. These shortcomings can generate future research opportunities and enable it to become more realistic and adaptive. We recommended including more observable factors and human behaviors that affect BP. Furthermore, we suggested that vital monitoring/logging and medication tuning are insufficient to improve hypertension control. There is also a need to observe and alter patient behavior and lifestyles.

• Journal of Preventive Medicine and Public Health
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• v.31 no.3 s.62
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• pp.384-394
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• 1998

In order to investigate the effect of the urinary excretion of sodium and potassium on the change on blood pressure over 3 years, 668 adolescents aged 13 years living in Kangwha area were investigated in a longitudinal follow-up study. Two measurements were taken on each blood pressure (diastolic, systolic) and the average of the two readings was used in the analysis. Sodium and potassium intake were estimated by the determination of those electrolytes in 24hr urine. The mixed model regression analysis was used to identify the effect of urinary sodium and potassium on the change of blood pressure after controlling for BMI of each age. On simple bivariate analysis no relationship was found between urinary sodium excretion and systolic or diastolic blood pressure among both male and female, however, a significant positive association between urinary potassium excretion and systolic blood pressure among male. The results of mixed regression analysis showed that the body mass index (BMI) were more influential that urinary electrolytes among this study subjects. It suggested that risk factors observed from the adults, may not be identical with that of the growing aged population. After control of the BMI and age, significant association between sodium and diastolic BP among male, and association between potassium and systolic BP among female, were found. In summary, the results indicate that growth has been more influential than dietary factor on blood pressure for growing aged population.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.60 no.8
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• pp.1606-1616
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• 2011

The blood pressure measuring equipment, which is being supplied and used most widely by being recognized convenience and accuracy now generally, is oscillometric blood pressure monitor. However, a change in blood pressure is basically influenced by diverse elements such as each individual's physiological status and physical condition. Thus, the measurement of blood pressure, which used single element called oscillation in blood pressure of being conveyed to cuff, is not considered on physiological elements such as cardiovascular system status and blood vessel stiffness index, and on external elements, thereby being quite in error. Accordingly, this study detected diverse bio-signals and body informations in each individual as the measurement subject such as ECG, PPG, and Korotkoff Sound in order to enhance convenience and accuracy of measuring blood pressure in the complex measurement equipment, thereby having extracted regression method for compensation in error of oscillometric blood pressure measurement on the wrist, and having improved accuracy of measuring blood pressure. To verify a method of improving accuracy, the blood pressure value in each of SBP, DBP, MAP was acquired through 4-stage experimental procedure targeting totally 51 subjects. Prior to experiment, the subjects were divided into two groups such as the experimental group for extracting regression method and the control group for verifying regression method. Its error was analyzed by comparing the reference blood pressure value, which was obtained through the auscultatory method, and the oscillometric blood pressure value on the wrist. To reduce the detected error, the blood pressure compensation regression method was calculated through multiple linear regression analysis on elements of blood pressure, individual body information, PTT, HR, K-Sound PSD change. Verification was carried out on improving significance and accuracy by applying the regression method to the data of control group. In the experimental results, as a result of confirming error on the reference blood pressure value in SBP, DBP, and MAP, which were acquired through applying regression method, the results of $-0.47{\pm}7.45$ mmHg, $-0.23{\pm}7.13$ mmHg, $0.06{\pm}6.39$ mmHg could be obtained. This is not only the numerical value of satisfying the sphygmomanometer reference of AAMI, but also shows the lower result than the numerical value in SBP : $-2.5{\pm}12.2$ mmHg, DBP : $-7.5{\pm}8.4$ mmHg, which is the mean error in the experimental results of Brram's research for verifying accuracy of Omron RX-M, which shows relatively high accuracy among wrist sphygmomanometers. Thus, the blood pressure compensation could be confirmed to be made within significant level.