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01-12-2021 | Hypertension | Research article

A longitudinal analysis of the progression from normal blood pressure to stage 2 hypertension: A 12-year Korean cohort

Authors: Eun Sun Yu, Kwan Hong, Byung Chul Chun

Published in: BMC Public Health | Issue 1/2021

Abstract

Background

The study aimed to estimate the incidence of and period of progression to stage 2 hypertension from normal blood pressure.

Methods

We selected a total of 21,172 normotensive individuals between 2003 and 2004 from the National Health Insurance Service-Health Screening and followed them up until 2015. The criteria for blood pressure were based on the American College of Cardiology/American Heart Association 2017 guideline (normal BP: SBP < 120 and DBP < 80 mmHg, elevated BP: SBP 120–129 and DBP < 80 mmHg, stage 1 hypertension: SBP 130–139 or DBP 80–89 mmHg, stage 2 hypertension: SBP ≥140 or DBP ≥ 90 mmHg). We classified the participants into four courses (Course A: normal BP → elevated BP → stage 1 hypertension→ stage 2 hypertension, Course B: normal BP → elevated BP → stage 2 hypertension, Course C: normal BP → stage 1 hypertension → stage 2 hypertension, Course D: normal BP → stage 2 hypertension) according to their progression from normal blood pressure to stage 2 hypertension.

Results

During the median 12.23 years of follow-up period, 52.8% (n= 11,168) and 23.6% (n=5004) of the participants had stage 1 and stage 2 hypertension, respectively. In particular, over 60 years old had a 2.8-fold higher incidence of stage 2 hypertension than 40–49 years old. After the follow-up period, 77.5% (n=3879) of participants with stage 2 hypertension were found to be course C (n= 2378) and D (n=1501). After the follow-up period, 77.5% (n=3879) of participants with stage 2 hypertension were found to be course C (n= 2378) and D (n=1501). The mean years of progression from normal blood pressure to stage 2 hypertension were 8.7±2.6 years (course A), 6.1±2.9 years (course B), 7.5±2.8 years (course C) and 3.2±2.0 years, respectively.

Conclusions

This study found that the incidence of hypertension is associated with the progression at each stage. We suggest that the strategies necessary to prevent progression to stage 2 hypertension need to be set differently for each target course.

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Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365(9455):217–23. https://doi.org/10.1016/S0140-6736(05)17741-1.PubMedCrossRef

Moore J. Hypertension: catching the silent killer. Nurse Pract. 2005;30(10):16–35.PubMedCrossRef

Carey RM, Whelton PK. Prevention, detection, evaluation, and management of high blood pressure in adults: synopsis of the 2017 American College of Cardiology/American Heart Association Hypertension Guideline. Ann Intern Med. 2018;168(5):351–8. https://doi.org/10.7326/M17-3203.PubMedCrossRef

Huang Y, Dai M, Deng Z, Huang X, Li H, Bai Y, et al. Clustering of risk factors and the risk of new-onset hypertension defined by the 2017 ACC/AHA Hypertension Guideline. J Hum Hypertens. 2019:1–6. https://doi.org/10.1038/s41371-019-0232-9.

Kim T-J, Lee J-W, Kang H-T, Cho M-C, Lim H-J, Kim J-Y, et al. Trends in Blood Pressure and Prevalence of Hypertension in Korean Adults Based on the 1998–2014 KNHANES. Yonsei Med J. 2018;59(3):356–65. https://doi.org/10.3349/ymj.2018.59.3.356.PubMedPubMedCentralCrossRef

Anderson GH. Effect of age on hypertension: analysis of over 4,800 referred hypertensive patients. Saudi J Kidney Dis Transpl. 1999;10(3):286 http://www.sjkdt.org/text.asp?1999/10/3/286/37237.PubMed

Kim Y, Han B-G, Group K. Cohort profile: the Korean genome and epidemiology study (KoGES) consortium. Int J Epidemiol. 2017;46(2):e20. https://doi.org/10.1093/ije/dyv316.PubMedCrossRef

Kishore J, Gupta N, Kohli C, Kumar N. Prevalence of hypertension and determination of its risk factors in rural Delhi. Int J Hypertens. 2016;6. https://doi.org/10.1155/2016/7962595.

Bosu WK, Aheto JM, Zucchelli E, Reilly S. Prevalence, awareness, and associated risk factors of hypertension in older adults in Africa: a systematic review and meta-analysis protocol. Syst Rev. 2017;6(1):192. https://doi.org/10.1186/s13643-017-0585-5.PubMedPubMedCentralCrossRef

10.

Falkner B. Hypertension in children and adolescents: epidemiology and natural history. Pediatr Nephrol. 2010;25(7):1219–24. https://doi.org/10.1007/s00467-009-1200-3.PubMedCrossRef

11.

Pannarale G, Moroni C, Acconcia M, Pannitteri G, Truscelli G, Valente L, et al. The natural history of prehypertension. A 20-year follow-up. Eur Rev Med Pharmacol Sci. 2017;21(6):1329–34.PubMed

12.

Bavishi C, Goel S, Messerli FH. Isolated systolic hypertension: an update after SPRINT. Am J Med. 2016;129(12):1251–8. https://doi.org/10.1016/j.amjmed.2016.08.032.PubMedCrossRef

13.

Poorolajal J, Farbakhsh F, Mahjub H, Bidarafsh A, Babaee E. How much excess body weight, blood sugar, or age can double the risk of hypertension? Pub Health. 2016;133:14–8. https://doi.org/10.1016/j.puhe.2015.10.014.CrossRef

14.

Hong K, Yu ES, Chun BC. Risk factors of the progression to hypertension and characteristics of natural history during progression: A national cohort study. Plos one. 2020;15(3):e0230538. https://doi.org/10.1371/journal.pone.0230538.PubMedPubMedCentralCrossRef

15.

Prabhakaran D, Jeemon P, Ghosh S, Shivashankar R, Ajay VS, Kondal D, et al. Prevalence and incidence of hypertension: results from a representative cohort of over 16,000 adults in three cities of South Asia. Indian Heart J. 2017;69(4):434–41. https://doi.org/10.1016/j.ihj.2017.05.021.PubMedPubMedCentralCrossRef

16.

Vokonas P, Kannel W, Cupples L. Epidemiology and risk of hypertension in the elderly: the Framingham study. J Hypertens Suppl. 1988;6(1):S3–9.PubMed

17.

Vasan RS, Larson MG, Leip EP, Kannel WB, Levy D. Assessment of frequency of progression to hypertension in non-hypertensive participants in the Framingham Heart Study: a cohort study. Lancet. 2001;358(9294):1682–6. https://doi.org/10.1016/S0140-6736(01)06710-1.PubMedCrossRef

18.

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42(6):1206–52. https://doi.org/10.1161/01.HYP.0000107251.49515.c2.PubMedCrossRef

Title: A longitudinal analysis of the progression from normal blood pressure to stage 2 hypertension: A 12-year Korean cohort
Authors: Eun Sun Yu
Kwan Hong
Byung Chul Chun
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Hypertension
Hypertension
Published in: BMC Public Health / Issue 1/2021
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-020-10115-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A longitudinal analysis of the progression from normal blood pressure to stage 2 hypertension: A 12-year Korean cohort

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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