• Korean Journal of Clinical Pharmacy
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• v.21 no.4
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• pp.364-375
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• 2011

Given that single blockade with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) can achieve only partial and undurable suppression of the Renin Angiotensin System (RAS), it has been hypothesized that dual blockage would be more beneficial in the management of blood pressure (BP) reduction and prevention of progressive chronic kidney disease (CKD) than either agent alone. Thus, it has been suggested that the combination of an ACEI and an ARB might provide renal benefits to hypertensive patients over and above BP reduction. However, this might also expose patients to additive or synergistic side effects. We attempted to conduct a systematic review to evaluate the benefits and harms of combination therapy in hypertensive patients with or without kidney diseases. MEDLINE and KoreaMed were searched for relevant randomized clinical trials in adult hypertensive patients with or without diabetes (restricted to 1997, limited to trials published in English). Results were summarized using the random-effects model, and between-studies heterogeneity was estimated with $I^2$. A final analysis of ten trials (23,928 patients) revealed that the combination of an ACEI and an ARB reduced blood pressure (SBP/DBP) by 3.95/2.02 mmHg (95% confidence interval [CI], -4.38 to -3.53/-2.33 to -1.71) compared with ACEI monotherapy, and 2.83/2.64 mmHg (95% CI, -3.25 to -2.41/-4.95 to -0.33) compared with ARB monotherapy. Eight trials (391 patients) demonstrated a significant reduction in 24h-proteinuria (weighted mean difference, 0.16 g/day, 95% CI, -0.26-0.05), but they did not translate into an improvement in GFR. Tests for heterogeneity showed no difference in effect among the studies. The combination therapy reduced proteinuria by 30% (95% CI, 23% to 37%) and 39% (95% CI, 31% to 48%) compared with ACEI monotherapy and ARB monotherapy, respectively. However, in patients who had proteinuria more than 0.5 g/day, the combination therapy failed to show significant reduction in urinary protein excretion. The current cumulative evidence suggests that diabetic patients with proteinuria on dual RAS blockade have an increase risk of adverse events such as hyperkalemia, hypotension, and so on, compared with ACEI or ARB alone. It is, therefore, proposed that the combination therapy should not be routinely used for the treatment of hypertension with or without compelling indications.

• Journal of Preventive Medicine and Public Health
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• v.19 no.2 s.20
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• pp.203-212
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• 1986

Hypertension is one of the most well known risk factors for cerebrovascular or coronary heart disease and is a major public health problem. Early detection and treatment of hypertension are essential, but the compliance of treatment on hypertension is not easy to achive. Hypertensive workers are being detected by the annual screening under the Labour Standard Law in Korea but the solidified control system for them is not existing. This study about workers 'Motive-Belief-Action in non-drug and drug treatment of their hypertension would be worthwhile to interpret how the workers actually behave in coping with hypertension, and also would be advisable to construct the follow-up program in Korea. In the field research process two criteria were used to select sample group. The first criterion included the workers who were screened to be hypertensive with their blood pressure above 160/95 in this survey. The second one was used to classify study-group respondents who had known their hypertension by successive annual screening. From such criteria a total of 156 male workers were sampled in 21 industries, the author interviewed them using the structured questionnaire which consisted of Belief-Motive-Action items about non-drug and drug treatment for hypertension with open-ended question on symptom of hypertension. The summary is as follows: 1) Sixty-one percent of respondents had ever checked their blood pressure somewhere besides the annual screening. 2) Most respondents(97.2%) complained no symptoms of hypertension at all. 3) Belief level of non-drug treatment was relatively high (82.1%-64.7%), but motive(55.1%-28.2%) and action(38.5%-16.7%) levels were low. 4) Belief level of drug treatment was relatively lower than that of non-drug treatment, blue collar workers showed higher artier level of drug treatment than white collar workers, and correlation coefficient between belief and motive on drug treatment was lower in group of not-recognizing their family history of hypertension than recognized group. Such findings indicated that belief on drug treatment of hypertensive workers would be problematic. 5) White collar workers showed significant lower correlation coefficients between Motive and Action of salt restriction, restriction of fatty diet and relaxation than blue collar workers. 6) Mild hypertension group showed low levels of Motive and Action of non-drug treatment(salt restriction, restriction of fatty diet and relaxation) and also showed low correlation coefficient between Belief and Motive of above non-drug treatment.

• Korea journal of population studies
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• v.6 no.1
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• pp.43-69
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• 1983

This study was conducted to make the life tables from specific causes of death in Korea. Both "Life tables of Korea in l978-79" and "the statistics on causes of death statistics in 1980" issued by Economic Planning Board were used as source of data for this study. Among the 58, 187 death certificates reported to the concerned authorities, 39, 801 causes were drawn for the purpose of this study. As a result, it is revealed that two thirds of men in Korea died from these 10 major causes of death. The summarized results are as follows: 1. According to recent statistics, 10 major causes of death in 1980 were shown in the order of 1) malignant neoplasms, 2) cerebrovascular disease, 3) accidents and adverse effects, 4)hypertensive disease, 5) ischaemic heart disease and heart attack, 6) chronic liver disease and cirrhosis, 7) tuberculosis, 8) pneumonia, bronchitis, emphysema and asthma, 9) suicide, 10) diabetes mellitis. 2. The major causes of death in Korea were very similar to those of developed countries such as West Germany, Denmark and Japan. This means that our pattern of death causes is almost approaching to that of developed countries. 3. Our crude death rate in 1980 was on the line of 6.6 per 1, 000 people. This is very low level, compared with 12.1 in West Germany and 10.0 in Denmark, however, our age sepcific death rate was on the verge of doubled level in each age category as to that of West Germany, Denmark and Japan. The fact tells us that our death rate is very high yet, especially in young and prime adult age, and the proportion of the aged is quite low. 4. Average ages of people died from malignant neoplasms, cerebro vascular diseases and hypertensive diseases were 63.1, 66.6, 67.3 respectively, however, that of accidents and adverse effect was only 42.5. This shows that accidents occur indifferently from age. 5. In the curve of eventual death probability, the curve of malignant neoplasms was the highest of all curves before 60 in age. However, the probability curve of eventually dying from accidents and adverse effects tends to decline with age. 6. In this study five life tables from major causes of death (four leading causes of death and of tuberculosis) were constructed for 1979. These life tables are reflecting accurately the effects of age distribution on the specific cause of death. In the surviving curje of these tables we can see that the curve of accidents is adversely related to age. While curves of neoplasms, hypertension and tuberculosis are not diminishing before 40 in age, they are going sharply downward after 50 in age.ard after 50 in age.

• Advances in nano research
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• v.17 no.3
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• pp.213-219
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• 2024

Nanotechnology is one of the critical factors involved in enhancing the sensitivity of serum biomarker detection. To explore the relationship between serum APN, Cystatin C and MMP-9 levels in patients with hypertension during pregnancy and the severity and prognosis of the disease. A total of 75 cases of hypertensive disorder complicating pregnancy (HDCP) patients who were admitted to the hospital from February 5, 2023 to May 9, 2024, were selected as the study group, and 70 healthy pregnant women who were in the same gestational week were selected as the control group. The serum APN, MMP-9 and Cys C levels of pregnant women and HDCP patients with different disease severity were compared between the two groups, and the receiver characteristic curve (ROC) was used to analyze its diagnostic value. The serum APN, MMP-9 and Cys C levels of HDCP patients with different prognosis were compared, and the factors affecting the prognosis of patients were analyzed by Logistic regression. Nanoparticles could aslo enable the sensitive detection and quantification of APN, Cystatin C, and MMP-9 in serum samples, thus increasing the accuracy of the study. The serum MMP-9 and Cys C levels of pregnant women in the study group were significantly increased, and the APN level was significantly decreased (P<0.05). Serum MMP-9 and Cys C levels in patients with pregnancy-induced hypertension, mild preeclampsia, and severe preeclampsia gradually increased (r=0.768, 0.766; P<0.001), and APN levels gradually decreased (r=-0.748, P< 0.001). In the diagnosis of patients with HDCP, the sensitivity, specificity and AUC of APN single diagnosis were 70.00%, 82.67% and 9.848 respectively. The sensitivity, specificity and AUC of MMP-9 single diagnosis were 82.86%, 74.67% and 298.300 respectively. The sensitivity, specificity and AUC of Cys C single diagnosis were 80.00%, 74.67% and 1.301 respectively. There were significant differences in age, BMI, parity, dysthymia, disease severity, APN, MMP-9 and Cys between patients with poor prognosis of HDCP and patients with good prognosis of HDCP (P<0.001). The patient's age, BMI, disease severity, APN, MMP-9 and Cys Cwere all related to HDCP. They were related risk factors of HDCP (P<0.05).

• 대한상한금궤의학회지
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• v.13 no.1
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• pp.1-19
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• 2021

Purpose : Sayeok-tang (Sini decoction, SND) is a cold-dispelling formula used for cold deficiency syndrome and is composed of Aconiti Lateralis Radix Preperata, Zingiberis Rhizoma, and Glycyrrhizae Radix et Rhizoma. It is used for diseases such as myocardial infarction, heart failure, acute and chronic gastroenteritis, and gastric effusion. This study proposes the possibility of expansion of basic research and clinical applications for ischemic heart disease (IHD) through systematic analysis of domestic and foreign studies on SND. Methods : We collected studies within the last 10 years on the use of SND in IHD and excluded those lacking relevance. Selected studies were classified by research method and the main themes of the studies were analyzed for each classification. Result: Out of 15 studies, there were 5 animal studies, 8 metabolite analyses in animals, 1 in vitro study, and 1 systematic review. Our review suggests that SND may be used as an adjuvant to nitroglycerin and percutaneous transluminal coronary angioplasty, and may improve symptoms and quality of life of patients with IHD. Myocardial protective effects through antioxidant, anti-inflammatory, anti-apoptotic, and anti-hypertensive actions were confirmed through these studies. Effects on carbohydrate, protein, and lipid metabolism were also reported. Conclusions : This study suggests that SND has potential as a treatment for IHD.

• The Journal of the Korea Contents Association
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• v.19 no.6
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• pp.461-470
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• 2019

In diabetes mellitus, renal disease is a common complication, characterized by increased urinary albumin excretion and reduced eGFR. According to KDIGO CKD stage classification, Korean characteristics were analyzed according to urinary albumin and eGFR using the National Health and Nutrition Examination Survey VI raw data. According to KDIGO classification, diabetic patients were classified as Low risk 72.0%, Moderate risk 19.3%, High risk 5.6% and Very high risk 3.0%. Low risk decreased from 74.7% to 52.2%, and moderate to very high risk increased from 25.4% to 47.8% as the duration of diabetes mellitus was prolonged. The risk factors were CKD stage 1 (HR 2.064) to stage 4 (HR 11.049), the highest risk of hypertension. The incidence of renal disease was elevated according to duration of hypertension and HR 0.42 of kidney disease was decreased in the group maintaining proper blood pressure. In the hypertensive patients, the group administered with target blood pressure had a reduction of the kidney disease by 42% than the group with the hypertension. Therefore, controlling and managing hypertension to target blood pressure is important for the prevention of kidney disease.

• Journal of Korean Physical Therapy Science
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• v.13 no.2
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• pp.67-83
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• 2006

The present study examined that in Vivo/Vitro test is investigated in normotensive sham-operated rats (NSR) and aldosterone-analogue deoxycorticosterone acetate (DOCA)-salt hypertensive rats (ADHR) and that the antihypertensive effect was induced by silver spike point (SSP) electrical stimulation at meridian points(CV-3, -4, Ki-12, SP-6, LR-3, BL-25, -28, -32, -52), specifically, such as aldosterone in 24 hour urine analysis from healthy volunteer. The gross examination and morphometric-histological changes, such as hypertrophy, production of necrotic tissues, and the changes of cell arrangement on the kidney, and adrenal gland were markedly observed in aldosterone-analogue DOCA-salt hypertensive rats compared with those from normotensive sham-operated rats. The systolic blood pressure, weight of kidney and adrenal gland were significantly increased in ADHR than that in NSR. The required time of PSS-induced resting tone was significantly increased in ADHR than that in NSR. However, the voltage-dependent K+ (Kv) currents were significantly decreased in ADHR than that in NSR. The urine analysis showed that the concentration of aldosterone was significantly decreased in resting state from the elderly people compared with those from the adolescent healthy volunteer. The current of 1 Hz continue type of SSP electrical stimulation significantly decreased in the concentration of aldosterone of 24 hour urine from the elderly people. These results suggest that the development of aldosterone analogue-induced hypertension is associated with changed the weight of kidney and adrenal gland, blood pressure, resting tone and Kv currents, which directly affects blood pressure. Therefore, the hypertension is a risk factor on cerebrovascular disease. Moreover, these results suggest that the diminished responsiveness to SSP electrical stimulation, especially current of 1Hz continue type, in elderly people may be, in part, related by the increased of antihypertensive effects.

• Korean Circulation Journal
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• v.52 no.11
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• pp.829-843
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• 2022

Background and Objectives: Despite remarkable reduction in cardiovascular disease (CVD) mortality, the burden has remained the leading cause of death. Since little research has focused on regional disparity in CVD mortality, this study aims to investigate its spatiotemporal trends in Korea from 1983 to 2019. Methods: Using the causes of death statistics in Korea, we analyzed the geographic variation in deaths from CVDs from 1983 to 2019. The sex and age-standardized mortality rate was calculated according to the 17 administrative regions. The analyses include all diseases of the circulatory system (International Classification of Diseases-10 codes, I00-I99), along with the following 6 subcategories which were not mutually exclusive: total heart disease (I00-I13 and I20-I51), hypertensive heart disease (I10-I13), ischemic heart disease (I20-I25), myocardial infarction (I21-I23), heart failure (I50), and cerebrovascular disease (I60-I69). Results: Overall, heart failure death rate increased across all regions, and other CVD death rates showed a decreasing trend. Regional disparity in mortality was substantial in the early 1980s but converged over time. In all types of cardiovascular mortality, Busan, Ulsan and Gyeongnam remained the highest, although they showed a downward trend like other regions. Jeju continued to have a relatively low CVD mortality rate. Conclusions: The regional disparity substantially decreased compared to the 1980s. However, the relatively high burden of CVD mortality in the southeastern region has not been fully resolved.

• Korean Journal of Occupational Health Nursing
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• v.12 no.1
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• pp.19-30
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• 2003

Increasing occupational cerebrovascular & cardiovascular disease, it becomes the most serious problem in the occupational health management. Hypertension is the most important risk factor of cerebrovascular & cardiovascular disease. Although treatment for hypertension has the priority, hypertension has not been managed systematically at the worksite. The objectives of this study were to investigate the actual situation of its treatment, figure out what factors can affect compliance for hypertension treatment and analyze the relations between compliance and employment status. Subjects were 28 workers who have been diagnosed as hypertension at periodic health examination, 20 workers who have been managed for hypertension at dispensary and 22 workers who were diagnosed during the study periods. The results of the study were as follows; 1. More women have been hired as part time workers and had lower education background and income than the full time workers. 2. Among the factors that have been known to affect the treatment compliance, part time workers had less supports from the company than full time workers. 3. We got the comparison of difference between compliance and variables that the factor grade of cure promotion and average ages are high in high compliance. In conclusion there were not the difference of compliance by employment status. But it was hard to rule out the selection vias because the sample size was so small. So it seems difficult to generalized the conclusion that employment status doesn't affect the treatment compliance.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.3
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• pp.740-743
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• 2009

Hypertension is one of the modifiable risk factors for stroke and heart disease. Lowering blood pressure is a primary or secondary preventative measure for stroke and heart disease. There are many antihypertension drugs. But these day there comes some side effect of antihypertension drugs. Headache, sexual dysfunction, inertia, dizziness, depression, and so on. So we use Bangpungtongsung -san to stage 1 hypertensive patients. After treatment with Bangpungtongsung-san, patients showed antihypertensive effect and improvement in general condition. The result of this study suggest that Bangpungtongsung-san might be usefully applied for the treatment of hypertension.