Cognitive dysfunction is relatively less considered a complication of hypertension. However, there is sufficient evidence to show that high blood pressure in middle age increases the risk of cognitive decline and dementia in old age. The greatest impact on cognitive function in those with hypertension is on executive or frontal lobe function, similar to the area most damaged in vascular dementia. Possible cognitive disorders associated with hypertension are vascular dementia, Alzheimer disease, and Lewy body dementia, listed in decreasing strength of association. The pathophysiology of cognitive dysfunction in individuals with hypertension includes brain atrophy, microinfarcts, microbleeds, neuronal loss, white matter lesions, network disruption, neurovascular unit damage, reduced cerebral blood flow, blood-brain barrier damage, enlarged perivascular damage, and proteinopathy. Antihypertensive drugs may reduce the risk of cognitive decline and dementia. Given the high prevalence of dementia and its impact on quality of life, treatment of hypertension to reduce cognitive decline may be a clinically relevant intervention.
Seo, Hyun-Ju;Kim, Chong-Soon;Chang, Yun-Kyun;Park, Il-Geun;Kim, Soo-Geun
Journal of Preventive Medicine and Public Health
/
v.39
no.3
/
pp.229-234
/
2006
Objectives: Cardiovascular disease is one of the main causes of death and morbidity in Korea. In this study, the prevalence and incidence of developing hypertension in a male-workers' cohort were investigated during 3-years follow-up with a view to find the risk factors that affected the development of hypertension. Methods: Among the 5,374 people who participated in a routine health check up, 3,852 people with normal blood pressure and who had no history of hypertension were prospectively followed up for 3 years. The classification of hypertension was based on the JNC7 report (the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure). Life style factors and underlying diseases that were related to the risk factors of hypertension were collected by using a self-report questionnaires via the internet. Results: The prevalence of hypertension was 28.3% (1,520/5,374) at the first screening (2001). It was found that the incidence in 2004 of hypertension for the follow-up subjects (3,711) who had normal blood pressure in 2001 was 7.6 per 100 person-year. Multiple logistic regression analysis of the variables related to the risk factors of hypertension was carried out. The relative risks were 1.037 (95% CI=1.022-1.053) as the age increased 1 year and 1.039 (95% CI=1.023-1.055) as the body mass index increased $1kg/m^2$. The relative risk for the prehypertensive group was 2.501 (95% CI=1.986-3.149) compared to the normotensive group. These results showed that age, body mass index and the baseline blood pressure were significantly related to the incidence of hypertension. Conclusions: The incidence of hypertension was 7.6 per 100 person-year during follow-up. It was concluded that the risk factors for developing hypertension in the short-term were age, BMI, and prehypertension; Especially, this showed that it is necessary for prehypertensives to manage their body weight and blood pressure to prevent hypertension in middle-age by modifying their life style.
Park Gyeong-Seon;Jang Yeon-Jin;Park Chun-Sik;Im Chae-Heon
Proceedings of the Korean Biophysical Society Conference
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1999.06a
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pp.61-62
/
1999
;The mechanisms inducing hypertension are actively investigated and are still challenging topics. Basically hypertension must be caused by the disorder of $Ca^{2+}$ metabolism in vascular smooth muscle, such as the increase of $Ca^{2+}$ influx, the decrease of ci+ efflux, or the change of sensitivity of contractile protein etc. The one of cause of the increase of ci+ influx may be the change of ci+ channel activity. Even though the relationships of ci+ channel activity and hypertension were studied using various hypertension models, still it is not clear how much change of $Ca^{2+}$ channel activity in diabetes mellitus (DM) induced hypertension is occurred. We induced DM hypertension in SD rat and compared the $Ca^{2+}$ channel activity with age-matched normotensive SD rat. For inducing DM hypertension, left kidney was removed with 200 gm rat and, after 1 month, 60 mg/kg of streptozotocin was injected into peritoneal space to induce diabetes mellitus. Usually after 4-6 weeks, hypertension was fully induced. For isolating vascular smooth muscle cells (VSMC), we used mesenteric arteriole (3rd - 4th branch of mesenteric artery) of which diameter is below 150 urn. VSMCs were isolated enzymatically. $Ca^{2+}$ current was measured using whole cell patch clamp technique. All experiments were performed at $37^{\circ}C$. The cell membrane area of VSMC of DM hypertensive rat is larger than that of control VSMC($36.6{\pm}3.64{\;}pF{\;}vs{\;}22.4{\pm}1.29{\;}pF, {\;}mean{\pm}S.E.$) When we compared the current amplitude, the $Ca^{2+}$ current amplitude in VSMC of DM hypertensive rat is much larger than that in VSMC of normotensive age-matched rat. After $Ca^{2+}$ current amplitude was normalized by cell membrane area, the current amplitude in DM hypertension is increased to $249.1{\pm}15.9{\;}%{\;}(mean{\pm}S.E.M)$, which means the ;absolute current amplitude is about 4 times larger in DM hypertension. When we compared the steady state activation and inactivation. there were no noticeable differences. From these results. one of cause of the DM hypertension is due to the increase of $Ca^{2+}$ current amplitude. But it need further study why the $Ca^{2+}$ current is so large in VSMC of DM hypertension and how much $Ca^{2+}$ influx through $Ca^{2+}$ channel contribute to the increase of intracellular $Ca^{2+}$ and eventually contribute to development of hypertension.ypertension.
Chungbuk CHP research team, Chungbuk CHP research team;Jeon, Mi-Yang
Research in Community and Public Health Nursing
/
v.14
no.3
/
pp.507-519
/
2003
Purpose: The purpose of this study was to identify the prevalence, health behaviors, and control of hypertension in rural areas in Korea. Method: A total of 927 subjects above age 20 were selected from the areas which fell under the jurisdiction of the 24 Community Health Center located in Chungcheongbuk-do. The employees in the Community Health Center visited and interviewed patients. Data were collected using a questionnaire from July to October 2002. Result: The result showed that women had higher hypertension prevalence rates than men and the increment of its rate leveled up according to age. The hypertension prevalence rate was significantly high when the monthly income was less than 1 million won, their type of the Medical Insurance was the Guardian, they were only able to read Korean characters, and they were bereaved of spouses. In the Health behavior related to hypertension, the hypertension group showed a significantly lower level than the non- hypertension group in terms of drinking rate, smoking rate, intake of salt and intake of meat. There was no significant difference in the exercise rate and coffee intake rate between these groups. In the degree of the obesity the hypertension group was significantly higher than the non-hypertension group. The factors related to hypertension were that the duration for the incidence of hypertension was 12 to 60 months and took up 41.2%. The places where the medical check-ups occurred were the Community Health Center at 46.6%, the medical institution was mostly hospitals recording 46.5%. There were 66.1% of the targets who knew well about their blood pressure and there were 64.7% people who received education about it. As for the education place, the rate of Community Health Center was mostly high and it stood at 77.0%. In the aspect of the management of hypertension, the targets who took medicine on a regular basis were up to 76.1% and the targets who measured blood pressure once a month happened to be about 46.1 %. The targets who always recorded their blood pressure were 3.8%, chest X-ray as a related examination of hypertension reached 32.6%, electrocardiogram examination was 36.2%, cholesterol and serum lipid examination took up 33.6%, and the eye ground examination took 7.3%, which showed the lowest level of all.
Purpose: This study aimed to suggest hypertension-related vocabularies which hypertensive patients can understand easily. Methods: The survey was conducted from 267 hypertensive patients and 162 public health nurses in 8 community health centers in Busan from October 21 to November 8, 2013. Data were analyzed using SPSS program and included descriptive statistics, t-test, ANOVA, and ${\chi}^2$ test. Results: The mean score for 26 hypertension-related vocabularies comprehension of hypertensive patients was 16.1 out of 26 points. The score was significantly lower among participants who were women, older, less educated, had limited ability to read and write, and had worse self-rated health. Over half of them didn't know the correct meaning of 9 out of 26 hypertension-related vocabularies. Twenty-two vocabularies such as hypertension that nurses used for health education were in different use, patients understand. Conclusion: Based on the results, it is recommended to educate hypertensive patients by replacing hypertension-related vocabularies with more easily understandable words when providing health information.
This study estimated the burden of disease due to hypertension in Korea in disability-adjusted life years(DALYs) using vital registration data and the National Health Examination Survey data. Firstly, we estimated the years life lost due to premature death (YLLs) of hypertension using the vital registration data. Secondly, to calculate the years lived with disability (YLDs), we estimated the average age at onset and disease duration using the National Health Examination Survey data. The disability weights for hypertension were estimated by person trade off method. Finally, the burden of hypertension was calculated in DALYs, which are the sum of YLLs and YLDs. The burden of hypertension for males was attributed mainly to YLD(97.9%). DALYs for females were also attributed mainly to YLD(96.7%). DALYS for males were 993,950 person-years and for females were 743,282 person-years. Results of this study provide a rational basis to plan a national health policy regarding the disease burden of hypertension in Korea. We will need accurate epidemiological study results and other study results of national burden of disease in Korea to get more accurate results of this burden of disease study.
Purpose: This study was conducted to compare health-related characteristics and self-care behavior between a controlled group and a non-controlled group of hypertension patients in a customized home visiting health service. Methods: This study was conducted as cross-sectional research. The subjects were 1,317 hypertension-controlled patients and 555 non-controlled ones. Data were collected using a structured questionnaire and analyzed by descriptive statistics, $x^2$-test, and t-test using the SPSS WIN 15.0 program. Results: Sociodemographic characteristics and self-care behavior were not significantly correlated between the groups. According to health-related characteristics, the health status was significantly higher in the hypertensioncontrolled group than in the non-controlled group. The cholesterol level was significantly lower in the hypertension-controlled group than in the non-controlled group. Conclusion: Attention should be paid to patients who are not in good health status in order to control their hypertension. Also, it is necessary to educate the patients in order for them to manage their hypertension and cholesterol.
Purpose: To determine the knowledge and treatment compliance with hypertension, directions for the aspects of implementation, and related factors to patients with hypertension using Primary Health Cares and Private Clinics Hospitals. Method: General characteristics and High blood pressure-related properties(17 questions), Hypertension knowledge measures(20 questions), and Treatment Compliance(22 questions) were used. Result: 1. The patients of Private Clinics Hospitals had statistically significantly higher drinking habits than Primary Health Care centers. The patients of Private Clinics Hospitals had statistically significantly higher rate of no family history of hypertension than Primary Health Care centers. 2. Primary Health Care centers had statistically significantly higher knowledge of hypertension than Private Clinics Hospitals. Primary Health Care centers had statistically significantly higher treatment compliance than Private Clinics Hospitals. Conclusion: Both Primary Health Care centers and Private Clinics Hospitals are high medication compliance but low lifestyle compliance with hypertension. We need to recognize the importance of lifestyle compliance, to apply proper programs and to provide therapists' aggressive intervention.
Objectives: The study was to propose strategies and directions how to manage the hypertension and diabetes in communities. Methods: The survey data from 606 patients with hypertension or diabetes based on Community Health Survey, 2013 were analyzed and the hypertension and diabetes projects in communities for last 10 years were reviewed. Results: The patients visiting the primary clinics had statistically significant lower rates than those of teaching hospitals in physician's recommendation experience, perception level of attention from doctors, self-efficacy and health habit practice level. Since the Hypertension and diabetes registration and management system in 2007, there have been several trials for management of hypertension and diabetes such as Chronic diseases management system on the primary clinics, Community based primary medical care pilot projects, Post-national health screening management, and Pilot project on reimbursement for chronic diseases care services. Conclusions: The upmost urgent task might be to have a support system for patients' self care affiliated with primary clinics. To achieve it, it is necessary to expand the current Hypertension and diabetes registration and management system into nation and to find a way to attract the active participation from primary clinics.
Purpose: This study was conducted to investigate the combined effects of abdominal obesity and alcohol drinking on the risk of hypertension in Korean adults (aged ${\geq}30yrs$). Methods: Data of 13,885 subjects from the sixth Korea National Health and Nutrition Examination Survey were analyzed. The multiple logistic regression tests were used for the analysis, including potential covariates of the model. Results: Frequency of drinking, typical drinking quantity, and frequency of binge drinking had a positive relation to hypertension. The odds ratio of hypertension for risk drinkers with abdominal obesity was 4.81 compared to non-risk drinkers with normal waist circumstance, whereas the odds ratios of hypertension for risk drinkers with normal waist circumstance and non-risk drinkers with abdominal obesity were 1.58 and 2.37 respectively. Conclusion: Both abdominal obesity and alcohol drinking patterns were strong risk factors of hypertension in the Korean adults. Risk drinkers with abdominal obesity showed a marked high risk in hypertension compared to those with a single condition alone.
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