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Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Hypertension | Research

Increasing trend in hypertension prevalence among Korean adolescents from 2007 to 2020

Authors: Peong Gang Park, Eujin Park, Hee Gyung Kang

Published in: BMC Public Health | Issue 1/2024

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Abstract

Background

The purpose of this study was to examine the prevalence of hypertension in Korean adolescents, its long-term trends, and factors associated with the development of hypertension.

Methods

Data of the Korea National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2020 were combined into three time periods (2007–2011, 2012–2016, and 2017–2020). A total of 11,146 Korean adolescents aged 10–18 were included in the analysis. The definition of hypertension was based on the 2017 American Academy of Pediatrics guidelines for hypertension.

Results

The age-adjusted prevalence of hypertension was 5.47%, 7.85%, and 9.92% in 2007–2011, 2012–2016, and 2017–2020, respectively. Long-term trend analysis using Joinpoint analysis over the observation period showed a significantly increasing trend in hypertension prevalence with a mean annual percentage change of 6.4%. Boys, those aged 13–15, those aged 16–18, overweight/obese, and those living in urban areas were more likely to develop hypertension (OR 1.980, 1.492, 3.180, 2.943, and 1.330, respectively).

Conclusion

The prevalence of hypertension in Korean adolescents was higher than the global prevalence of hypertension and showed an increase over a 13–year period. Targeted strategies for prevention and early detection of hypertension are needed in this population.
Literature
1.
go back to reference Robinson CH, Chanchlani R. High blood pressure in children and adolescents: current perspectives and strategies to improve future kidney and Cardiovascular Health. Kidney Int Rep. 2022;7(5):954–70.PubMedPubMedCentralCrossRef Robinson CH, Chanchlani R. High blood pressure in children and adolescents: current perspectives and strategies to improve future kidney and Cardiovascular Health. Kidney Int Rep. 2022;7(5):954–70.PubMedPubMedCentralCrossRef
2.
go back to reference Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR et al. Clinical practice Guideline for Screening and Management of High Blood pressure in children and adolescents. Pediatrics. 2017;140(3). Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR et al. Clinical practice Guideline for Screening and Management of High Blood pressure in children and adolescents. Pediatrics. 2017;140(3).
3.
go back to reference Li S, Chen W, Srinivasan SR, Berenson GS. Childhood blood pressure as a predictor of arterial stiffness in young adults: the bogalusa heart study. Hypertension. 2004;43(3):541–6.PubMedCrossRef Li S, Chen W, Srinivasan SR, Berenson GS. Childhood blood pressure as a predictor of arterial stiffness in young adults: the bogalusa heart study. Hypertension. 2004;43(3):541–6.PubMedCrossRef
4.
go back to reference Juhola J, Magnussen CG, Berenson GS, Venn A, Burns TL, Sabin MA, et al. Combined effects of child and adult elevated blood pressure on subclinical atherosclerosis: the International Childhood Cardiovascular Cohort Consortium. Circulation. 2013;128(3):217–24.PubMedCrossRef Juhola J, Magnussen CG, Berenson GS, Venn A, Burns TL, Sabin MA, et al. Combined effects of child and adult elevated blood pressure on subclinical atherosclerosis: the International Childhood Cardiovascular Cohort Consortium. Circulation. 2013;128(3):217–24.PubMedCrossRef
5.
go back to reference Aatola H, Magnussen CG, Koivistoinen T, Hutri-Kähönen N, Juonala M, Viikari JS, et al. Simplified definitions of elevated pediatric blood pressure and high adult arterial stiffness. Pediatrics. 2013;132(1):e70–6.PubMedCrossRef Aatola H, Magnussen CG, Koivistoinen T, Hutri-Kähönen N, Juonala M, Viikari JS, et al. Simplified definitions of elevated pediatric blood pressure and high adult arterial stiffness. Pediatrics. 2013;132(1):e70–6.PubMedCrossRef
6.
go back to reference Baroncini LAV, Sylvestre LC, Baroncini CV, Pecoits RF. Assessment of Carotid Intima-Media thickness as an early marker of vascular damage in Hypertensive Children. Arq Bras Cardiol. 2017;108(5):452–7.PubMedPubMedCentral Baroncini LAV, Sylvestre LC, Baroncini CV, Pecoits RF. Assessment of Carotid Intima-Media thickness as an early marker of vascular damage in Hypertensive Children. Arq Bras Cardiol. 2017;108(5):452–7.PubMedPubMedCentral
7.
go back to reference Sorof JM, Alexandrov AV, Cardwell G, Portman RJ. Carotid artery intimal-medial thickness and left ventricular hypertrophy in children with elevated blood pressure. Pediatrics. 2003;111(1):61–6.PubMedCrossRef Sorof JM, Alexandrov AV, Cardwell G, Portman RJ. Carotid artery intimal-medial thickness and left ventricular hypertrophy in children with elevated blood pressure. Pediatrics. 2003;111(1):61–6.PubMedCrossRef
8.
go back to reference Brown DW, Giles WH, Croft JB. Left ventricular hypertrophy as a predictor of coronary heart disease mortality and the effect of hypertension. Am Heart J. 2000;140(6):848–56.PubMedCrossRef Brown DW, Giles WH, Croft JB. Left ventricular hypertrophy as a predictor of coronary heart disease mortality and the effect of hypertension. Am Heart J. 2000;140(6):848–56.PubMedCrossRef
9.
go back to reference Desai CS, Ning H, Lloyd-Jones DM. Competing cardiovascular outcomes associated with electrocardiographic left ventricular hypertrophy: the atherosclerosis risk in communities Study. Heart. 2012;98(4):330–4.PubMedCrossRef Desai CS, Ning H, Lloyd-Jones DM. Competing cardiovascular outcomes associated with electrocardiographic left ventricular hypertrophy: the atherosclerosis risk in communities Study. Heart. 2012;98(4):330–4.PubMedCrossRef
10.
go back to reference Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol. 2010;55(13):1318–27.PubMedCrossRef Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol. 2010;55(13):1318–27.PubMedCrossRef
11.
go back to reference Flynn JT. Microalbuminuria in Children with primary hypertension. J Clin Hypertens (Greenwich). 2016;18(10):962–5.PubMedCrossRef Flynn JT. Microalbuminuria in Children with primary hypertension. J Clin Hypertens (Greenwich). 2016;18(10):962–5.PubMedCrossRef
12.
go back to reference Murgan I, Beyer S, Kotliar KE, Weber L, Bechtold-Dalla Pozza S, Dalla Pozza R, et al. Arterial and retinal vascular changes in hypertensive and prehypertensive adolescents. Am J Hypertens. 2013;26(3):400–8.PubMedCrossRef Murgan I, Beyer S, Kotliar KE, Weber L, Bechtold-Dalla Pozza S, Dalla Pozza R, et al. Arterial and retinal vascular changes in hypertensive and prehypertensive adolescents. Am J Hypertens. 2013;26(3):400–8.PubMedCrossRef
13.
go back to reference Litwin M, Niemirska A, Sladowska-Kozlowska J, Wierzbicka A, Janas R, Wawer ZT, et al. Regression of target organ damage in children and adolescents with primary hypertension. Pediatr Nephrol. 2010;25(12):2489–99.PubMedPubMedCentralCrossRef Litwin M, Niemirska A, Sladowska-Kozlowska J, Wierzbicka A, Janas R, Wawer ZT, et al. Regression of target organ damage in children and adolescents with primary hypertension. Pediatr Nephrol. 2010;25(12):2489–99.PubMedPubMedCentralCrossRef
14.
go back to reference Chung J, Robinson CH, Yu A, Bamhraz AA, Ewusie JE, Sanger S et al. Risk of Target Organ damage in children with primary ambulatory hypertension: a systematic review and Meta-analysis. Hypertension. 2023. Chung J, Robinson CH, Yu A, Bamhraz AA, Ewusie JE, Sanger S et al. Risk of Target Organ damage in children with primary ambulatory hypertension: a systematic review and Meta-analysis. Hypertension. 2023.
15.
go back to reference Daniels SR. Understanding the global prevalence of hypertension in children and adolescents. JAMA Pediatr. 2019;173(12):1133–4.PubMedCrossRef Daniels SR. Understanding the global prevalence of hypertension in children and adolescents. JAMA Pediatr. 2019;173(12):1133–4.PubMedCrossRef
16.
go back to reference Song P, Zhang Y, Yu J, Zha M, Zhu Y, Rahimi K, et al. Global prevalence of hypertension in children: a systematic review and Meta-analysis. JAMA Pediatr. 2019;173(12):1154–63.PubMedPubMedCentralCrossRef Song P, Zhang Y, Yu J, Zha M, Zhu Y, Rahimi K, et al. Global prevalence of hypertension in children: a systematic review and Meta-analysis. JAMA Pediatr. 2019;173(12):1154–63.PubMedPubMedCentralCrossRef
17.
go back to reference Hardy ST, Sakhuja S, Jaeger BC, Urbina EM, Suglia SF, Feig DI, et al. Trends in blood pressure and hypertension among US children and adolescents, 1999–2018. JAMA Netw Open. 2021;4(4):e213917.PubMedPubMedCentralCrossRef Hardy ST, Sakhuja S, Jaeger BC, Urbina EM, Suglia SF, Feig DI, et al. Trends in blood pressure and hypertension among US children and adolescents, 1999–2018. JAMA Netw Open. 2021;4(4):e213917.PubMedPubMedCentralCrossRef
18.
19.
go back to reference Ye X, Yi Q, Shao J, Zhang Y, Zha M, Yang Q, et al. Trends in Prevalence of Hypertension and Hypertension Phenotypes among Chinese Children and adolescents over two decades (1991–2015). Front Cardiovasc Med. 2021;11:8:627741.CrossRef Ye X, Yi Q, Shao J, Zhang Y, Zha M, Yang Q, et al. Trends in Prevalence of Hypertension and Hypertension Phenotypes among Chinese Children and adolescents over two decades (1991–2015). Front Cardiovasc Med. 2021;11:8:627741.CrossRef
20.
go back to reference Mohan B, Verma A, Singh K, Singh K, Sharma S, Bansal R, et al. Prevalence of sustained hypertension and obesity among urban and rural adolescents: a school-based, cross-sectional study in North India. BMJ Open. 2019;8(9):e027134.CrossRef Mohan B, Verma A, Singh K, Singh K, Sharma S, Bansal R, et al. Prevalence of sustained hypertension and obesity among urban and rural adolescents: a school-based, cross-sectional study in North India. BMJ Open. 2019;8(9):e027134.CrossRef
21.
go back to reference Song K, Jung SY, Yang J, Lee HS, Kim HS, Chae HW. Change in prevalence of hypertension among Korean children and adolescents during the Coronavirus Disease 2019 (COVID-19) outbreak: a Population-based study. Child (Basel). 2023;10(1). Song K, Jung SY, Yang J, Lee HS, Kim HS, Chae HW. Change in prevalence of hypertension among Korean children and adolescents during the Coronavirus Disease 2019 (COVID-19) outbreak: a Population-based study. Child (Basel). 2023;10(1).
22.
go back to reference Oh K, Kim Y, Kweon S, Kim S, Yun S, Park S, et al. Korea National Health and Nutrition Examination Survey, 20th anniversary: accomplishments and future directions. Epidemiol Health. 2021;43:e2021025.PubMedPubMedCentralCrossRef Oh K, Kim Y, Kweon S, Kim S, Yun S, Park S, et al. Korea National Health and Nutrition Examination Survey, 20th anniversary: accomplishments and future directions. Epidemiol Health. 2021;43:e2021025.PubMedPubMedCentralCrossRef
23.
go back to reference Graves JW, Tibor M, Murtagh B, Klein L, Sheps SG. The Accoson Greenlight 300, the first non-automated mercury-free blood pressure measurement device to pass the International Protocol for blood pressure measuring devices in adults. Blood Press Monit. 2004;9(1):13–7.PubMedCrossRef Graves JW, Tibor M, Murtagh B, Klein L, Sheps SG. The Accoson Greenlight 300, the first non-automated mercury-free blood pressure measurement device to pass the International Protocol for blood pressure measuring devices in adults. Blood Press Monit. 2004;9(1):13–7.PubMedCrossRef
24.
go back to reference Stergiou GS, Alpert B, Mieke S, Asmar R, Atkins N, Eckert S, et al. A Universal Standard for the Validation of Blood Pressure Measuring Devices: Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) collaboration Statement. Hypertension. 2018;71(3):368–74.PubMedCrossRef Stergiou GS, Alpert B, Mieke S, Asmar R, Atkins N, Eckert S, et al. A Universal Standard for the Validation of Blood Pressure Measuring Devices: Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) collaboration Statement. Hypertension. 2018;71(3):368–74.PubMedCrossRef
25.
go back to reference Park SJ, Shin JI. Comparative Analysis of American Academy of Pediatrics and European Society of Hypertension Guidelines for the diagnosis and treatment of Pediatric Hypertension. Child Kidney Dis. 2021;25(2):71–7.CrossRef Park SJ, Shin JI. Comparative Analysis of American Academy of Pediatrics and European Society of Hypertension Guidelines for the diagnosis and treatment of Pediatric Hypertension. Child Kidney Dis. 2021;25(2):71–7.CrossRef
26.
go back to reference The fourth report on the. Diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(2 Suppl 4th Report):555–76. The fourth report on the. Diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(2 Suppl 4th Report):555–76.
27.
go back to reference Lee CG, Moon JS, Choi J-M, Nam CM, Lee SY, Oh K, et al. Normative blood pressure references for Korean children and adolescents. Korean J Pediatr. 2008;51(1):33–41.CrossRef Lee CG, Moon JS, Choi J-M, Nam CM, Lee SY, Oh K, et al. Normative blood pressure references for Korean children and adolescents. Korean J Pediatr. 2008;51(1):33–41.CrossRef
28.
go back to reference Kim JH, Yun S, Hwang SS, Shim JO, Chae HW, Lee YJ, et al. The 2017 Korean National Growth Charts for children and adolescents: development, improvement, and prospects. Korean J Pediatr. 2018;61(5):135–49.PubMedPubMedCentralCrossRef Kim JH, Yun S, Hwang SS, Shim JO, Chae HW, Lee YJ, et al. The 2017 Korean National Growth Charts for children and adolescents: development, improvement, and prospects. Korean J Pediatr. 2018;61(5):135–49.PubMedPubMedCentralCrossRef
29.
go back to reference Ha J, Lee SW, Yon DK. Ten-year trends and prevalence of asthma, allergic rhinitis, and atopic dermatitis among the Korean population, 2008–2017. Clin Exp Pediatr. 2020;63(7):278–83.PubMedPubMedCentralCrossRef Ha J, Lee SW, Yon DK. Ten-year trends and prevalence of asthma, allergic rhinitis, and atopic dermatitis among the Korean population, 2008–2017. Clin Exp Pediatr. 2020;63(7):278–83.PubMedPubMedCentralCrossRef
31.
go back to reference Irimata KE, Bastian BA, Clarke TC, Curtin SC, Badwe R, Rui P. Guidance for selecting Model options in the National Cancer Institute Joinpoint Regression Software. Vital Health Stat. 2022;1(194):1–22. Irimata KE, Bastian BA, Clarke TC, Curtin SC, Badwe R, Rui P. Guidance for selecting Model options in the National Cancer Institute Joinpoint Regression Software. Vital Health Stat. 2022;1(194):1–22.
32.
go back to reference Wilson JR, Lorenz KA. Weighted logistic regression model. Modeling binary correlated responses using SAS, SPSS and R. Cham: Springer International Publishing; 2015. pp. 81–102. Wilson JR, Lorenz KA. Weighted logistic regression model. Modeling binary correlated responses using SAS, SPSS and R. Cham: Springer International Publishing; 2015. pp. 81–102.
33.
go back to reference Vale S, Trost SG, Rêgo C, Abreu S, Mota J. Physical activity, obesity status, and blood pressure in Preschool Children. J Pediatr. 2015;167(1):98–102.PubMedCrossRef Vale S, Trost SG, Rêgo C, Abreu S, Mota J. Physical activity, obesity status, and blood pressure in Preschool Children. J Pediatr. 2015;167(1):98–102.PubMedCrossRef
34.
go back to reference Kaelber DC, Liu W, Ross M, Localio AR, Leon JB, Pace WD, et al. Comparative Effectiveness Research through Collaborative Electronic Reporting (CER2) Consortium. Diagnosis and Medication Treatment of Pediatric Hypertension: a retrospective cohort study. Pediatrics. 2016;138(6):e20162195.PubMedPubMedCentralCrossRef Kaelber DC, Liu W, Ross M, Localio AR, Leon JB, Pace WD, et al. Comparative Effectiveness Research through Collaborative Electronic Reporting (CER2) Consortium. Diagnosis and Medication Treatment of Pediatric Hypertension: a retrospective cohort study. Pediatrics. 2016;138(6):e20162195.PubMedPubMedCentralCrossRef
35.
go back to reference Lurbe E, Agabiti-Rosei E, Cruickshank JK, Dominiczak A, Erdine S, Hirth A, et al. 2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertens. 2016;34(10):1887–920.PubMedCrossRef Lurbe E, Agabiti-Rosei E, Cruickshank JK, Dominiczak A, Erdine S, Hirth A, et al. 2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertens. 2016;34(10):1887–920.PubMedCrossRef
36.
go back to reference Dasgupta K, O’Loughlin J, Chen S, Karp I, Paradis G, Tremblay J, Hamet P, Pilote L. Emergence of sex differences in prevalence of high systolic blood pressure: analysis of a longitudinal adolescent cohort. Circulation. 2006;114(24):2663–70.PubMedCrossRef Dasgupta K, O’Loughlin J, Chen S, Karp I, Paradis G, Tremblay J, Hamet P, Pilote L. Emergence of sex differences in prevalence of high systolic blood pressure: analysis of a longitudinal adolescent cohort. Circulation. 2006;114(24):2663–70.PubMedCrossRef
37.
go back to reference Cheng HL, Garden FL, Skilton MR, Johnson C, Webster J, Grimes CA et al. Impact of growth, gonadal hormones, adiposity and the sodium-to-potassium ratio on longitudinal adolescent measures of blood pressure at puberty. J Hum Hypertens. 2022. Cheng HL, Garden FL, Skilton MR, Johnson C, Webster J, Grimes CA et al. Impact of growth, gonadal hormones, adiposity and the sodium-to-potassium ratio on longitudinal adolescent measures of blood pressure at puberty. J Hum Hypertens. 2022.
38.
go back to reference Cai L, Wu Y, Wilson RF, Segal JB, Kim MT, Wang Y. Effect of childhood obesity prevention programs on blood pressure: a systematic review and meta-analysis. Circulation. 2014;129(18):1832–9.PubMedPubMedCentralCrossRef Cai L, Wu Y, Wilson RF, Segal JB, Kim MT, Wang Y. Effect of childhood obesity prevention programs on blood pressure: a systematic review and meta-analysis. Circulation. 2014;129(18):1832–9.PubMedPubMedCentralCrossRef
39.
go back to reference Jebeile H, Kelly AS, O’Malley G, Baur LA. Obesity in children and adolescents: epidemiology, causes, assessment, and management. Lancet Diabetes Endocrinol. 2022;10(5):351–65.PubMedPubMedCentralCrossRef Jebeile H, Kelly AS, O’Malley G, Baur LA. Obesity in children and adolescents: epidemiology, causes, assessment, and management. Lancet Diabetes Endocrinol. 2022;10(5):351–65.PubMedPubMedCentralCrossRef
40.
go back to reference Azegami T, Uchida K, Sato Y, Murai-Takeda A, Inokuchi M, Hayashi K et al. Secular trends and age-specific distribution of blood pressure in Japanese adolescents aged 12–18 years in 2000–2019. Hypertens Res. 2023 Sep 15. Epub ahead of print. Azegami T, Uchida K, Sato Y, Murai-Takeda A, Inokuchi M, Hayashi K et al. Secular trends and age-specific distribution of blood pressure in Japanese adolescents aged 12–18 years in 2000–2019. Hypertens Res. 2023 Sep 15. Epub ahead of print.
41.
42.
go back to reference Ejike CECC. Prevalence of hypertension in Nigerian children and adolescents: a systematic review and Trend Analysis of Data from the Past Four decades. J Trop Pediatr. 2017;1(3):229–41. Ejike CECC. Prevalence of hypertension in Nigerian children and adolescents: a systematic review and Trend Analysis of Data from the Past Four decades. J Trop Pediatr. 2017;1(3):229–41.
43.
go back to reference Cho H, Kim JH. Secular trends in hypertension and elevated blood pressure among Korean children and adolescents in the Korea National Health and Nutrition Examination Survey 2007–2015. J Clin Hypertens (Greenwich). 2020;22(4):590–7.PubMedCrossRef Cho H, Kim JH. Secular trends in hypertension and elevated blood pressure among Korean children and adolescents in the Korea National Health and Nutrition Examination Survey 2007–2015. J Clin Hypertens (Greenwich). 2020;22(4):590–7.PubMedCrossRef
44.
go back to reference Seo E, Jung S, Lee H, Kim HC. Sex-specific trends in the prevalence of hypertension and the number of people with hypertension: analysis of the Korea National Health and Nutrition Examination Survey (KNHANES) 1998–2018. Korean Circ J. 2022;52(5):382–92.PubMedPubMedCentralCrossRef Seo E, Jung S, Lee H, Kim HC. Sex-specific trends in the prevalence of hypertension and the number of people with hypertension: analysis of the Korea National Health and Nutrition Examination Survey (KNHANES) 1998–2018. Korean Circ J. 2022;52(5):382–92.PubMedPubMedCentralCrossRef
45.
go back to reference Jang S, Kim ST, Kim YK, Song YH. Association of blood pressure and hypertension between parents and offspring: the Korea National Health and Nutrition Examination Survey. Hypertens Res. 2023;46(2):368–76.PubMedCrossRef Jang S, Kim ST, Kim YK, Song YH. Association of blood pressure and hypertension between parents and offspring: the Korea National Health and Nutrition Examination Survey. Hypertens Res. 2023;46(2):368–76.PubMedCrossRef
46.
go back to reference Wang NY, Young JH, Meoni LA, Ford DE, Erlinger TP, Klag MJ. Blood pressure change and risk of hypertension associated with parental hypertension: the Johns Hopkins Precursors Study. Arch Intern Med. 2008;168(6):643–8.PubMedCrossRef Wang NY, Young JH, Meoni LA, Ford DE, Erlinger TP, Klag MJ. Blood pressure change and risk of hypertension associated with parental hypertension: the Johns Hopkins Precursors Study. Arch Intern Med. 2008;168(6):643–8.PubMedCrossRef
47.
go back to reference Chen X, Wang Y. Tracking of blood pressure from childhood to adulthood: a systematic review and meta-regression analysis. Circulation. 2008;117(25):3171–80.PubMedPubMedCentralCrossRef Chen X, Wang Y. Tracking of blood pressure from childhood to adulthood: a systematic review and meta-regression analysis. Circulation. 2008;117(25):3171–80.PubMedPubMedCentralCrossRef
Metadata
Title
Increasing trend in hypertension prevalence among Korean adolescents from 2007 to 2020
Authors
Peong Gang Park
Eujin Park
Hee Gyung Kang
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-18093-w

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