순환기 질환과 안질환 유병의 연관성과 위험비

홍기훈(Ki Hoon Hong),박지은(Jieun Park),김지혜(Jihye Kim),김소라(So Ra Kim) 한국안광학회 2019 한국안광학회지 Vol.24 No.2

Purpose: This study aimed to analyze the prevalence and correlation between circulatory and ocular diseases, and investigate the odds ratio (OR) between the two disease groups. Methods: The prevalence of circulatory and ocular diseases based on age and sex was determined by analyzing the raw data from the 5th National Health and Nutrition Survey (2012). The χ2-test was used to determine the correlation between circulatory and ocular diseases and OR of ocular diseases caused by circulatory diseases was further analyzed. Results: The prevalence of circulatory diseases, such as hypertension, dyslipidemia, angina pectoris, stroke, and myocardial infarction, were 24.4%, 11.9%, 2.5%, 1.9%, and 1.2%, respectively. The prevalence of the above-mentioned diseases with the exception of dyslipidemia was found to increase with age. Among the 11 ocular diseases analyzed, cataract, retinal abnormality, visual field defects, diabetic retinopathy, glaucoma risk factors, and ptosis were associated with all of the circulatory diseases described herein. Analysis of circulatory diseases with the highest OR for the onset of ocular diseases showed: angina pectoris (6.64 times) with cataracts, hypertension (2.98 times) with retinal abnormality, stroke (2.94 times) with visual field defect, angina pectoris (7.32 times) with diabetic retinopathy, glaucoma risk factors (2.93 times) with myocardial infarction and ptosis (3.32 times) with angina pectoris, respectively. Macular degeneration showed the highest OR (3.52 times) with hypertension. Similary, dry eye was correlated with dyslipidemia (OR: 1.89) and glaucoma was correlated with hypertension (OR: 2.05). When the OR between circulatory and ocular diseases were analyzed based on age, the highest association was observed between dyslipidemia, stroke, and hypertension with retinal abnormality (2.23 times), visual field defects (9.39 times), and macular degeneration (10.25 times), respectively, in their 40s. In their 50s, the highest OR was observed in diabetic retinopathy (2.71 times with hypertension ~ 11.81 times with angina pectoris) regardless of the type of circulatory diseases. In their 60s, diabetic retinopathy showed highest OR with hypertension (2.06 times), dyslipidemia (2.33 times), and angina pectoris (3.90 times), whereas stroke and myocardial infarction were highly associated with ptosis (3.10 times), and glaucoma risk factors (3.64 times). In their 70s and above, the highest OR was observed between hypertension and macular degeneration (1.55 times), angina pectoris and ptosis (1.61 times), and stroke and diabetic retinopathy (3.66 times). Conclusions: Based on the results, the OR as well as the type of ocular diseases correlating with circulatory diseases were found to vary according to the type of the circulatory disease. It was also revealed that the ocular disease with the highest OR was changed by the age of the individual. Therefore, it is possible to infer the type and rank of ocular diseases that can occur in patients with circulatory diseases based on age, which may be helpful in preventing the onset or treating the disease.

Chronic periodontal disease is related with newly developing hypertension: a nationwide cohort study

Park Jung-Hyun,Kang Min Kyoung,Leem Gwang Hyun,Kim Jin-Woo,송태진 대한고혈압학회 2024 Clinical Hypertension Vol.30 No.-

Periodontal disease (PD) is a condition that can be treated and managed. This study aimed to determine if chronic PD status is associated with the risk of developing hypertension, utilizing data from the National Health Insurance Database of Korea.Participants who received oral health examinations both in 2003 and in 2005–2006 were included. Those with a history of hypertension were excluded. Hypertension was defined as at least one outpatient or inpatient claim diagnosis (primary or secondary) of hypertension (International Classification of Diseases (ICD)-10 codes I10-I11) with prescription for antihypertensive medication or at least one incident of systolic blood pressure greater than 140 mmHg or diastolic blood pressure greater than 90 mmHg during a health examination. Changes of PD status was determined during two oral examinations. Study participants were divided into 4 groups according to the changes of PD status: PD-free (those consistently free of disease in both exams), PD-recovered (individuals with disease initially but not in the second exam), PD-developed (no disease initially, but present in the second exam), and PD-chronic (disease throughout both exams). The incidence of hypertension after the second oral health examination (index date) was monitored. Participants were observed from the index date until the earliest occurrence of hypertension onset, mortality, or December 2020.The study comprised 706,584 participants: 253,003(35.8%) in the PD-free group, 140,143(19.8%) in the PD-recovered group, 132,397(18.7%) in the PD-developed group, and 181,041(25.6%) in the PD-chronic group. Over a median follow-up duration of 14.3 years, 239,937 (34.0%) cases of hypertension were recorded. The PD-recovered group had a lower risk of hypertension compared to the PD-chronic group, while the PD-developed group had a higher risk of hypertension compared to the PD-free group.Chronic PD is associated with an increased risk of developing hypertension. Although the increase in risk is modest, recovery from PD may have beneficial effects in reducing hypertension risk. Further studies are needed to confirm the importance of regular dental examinations and effective management of PD to reduce hypertension risk. Background Periodontal disease (PD) is a condition that can be treated and managed. This study aimed to determine if chronic PD status is associated with the risk of developing hypertension, utilizing data from the National Health Insurance Database of Korea. Methods Participants who received oral health examinations both in 2003 and in 2005–2006 were included. Those with a history of hypertension were excluded. Hypertension was defined as at least one outpatient or inpatient claim diagnosis (primary or secondary) of hypertension (International Classification of Diseases (ICD)-10 codes I10-I11) with prescription for antihypertensive medication or at least one incident of systolic blood pressure greater than 140 mmHg or diastolic blood pressure greater than 90 mmHg during a health examination. Changes of PD status was determined during two oral examinations. Study participants were divided into 4 groups according to the changes of PD status: PD-free (those consistently free of disease in both exams), PD-recovered (individuals with disease initially but not in the second exam), PD-developed (no disease initially, but present in the second exam), and PD-chronic (disease throughout both exams). The incidence of hypertension after the second oral health examination (index date) was monitored. Participants were observed from the index date until the earliest occurrence of hypertension onset, mortality, or December 2020. Results The study comprised 706,584 participants: 253,003(35.8%) in the PD-free group, 140,143(19.8%) in the PD-recovered group, 132,397(18.7%) in the PD-developed group, and 181,041(25.6%) in the PD-chronic group. Over a median follow-up duration of 14.3 years, 239,937 (34.0%) cases of hypertension were recorded. The PD-recovered group had a lower risk of hypertension compared to the PD-chronic group, while the PD-developed group had a higher risk of hypertension compared to the PD-free group. Conclusion Chronic PD is associated with an increased risk of developing hypertension. Although the increase in risk is modest, recovery from PD may have beneficial effects in reducing hypertension risk. Further studies are needed to confirm the importance of regular dental examinations and effective management of PD to reduce hypertension risk.

Reviews : Adrenergic Genetic Mechanisms in Hypertension and Hypertensive Kidney Disease

( Sun Woo Kang ) 대한전해질학회 2013 Electrolytes & Blood Pressure Vol.11 No.1

Catecholamine secretory traits were significantly heritable, as were stress-induced blood pressure changes. Tyrosine hydroxylase (TH) is the rate-limiting enzyme in catecholamine biosynthesis. In the tyrosine hyroxylase promoter, significant associations were found for urinary catecholamine excretion and for blood pressure response to stress. TH promoter haplotype 2 (TGGG) showed pleiotropy, increasing both norepinephrine excretion and blood pressure during stress. In hypertension, 2 independent case-control studies (1,266 subjects with 53% women and 927 subjects with 24% women) replicated the effect of C-824T in the determination of blood pressure. Chromogranin A (CHGA) plays a fundamental role in the biogenesis of catecholamine secretory granules. Changes in the storage and release of CHGA in clinical and experimental hypertension prompted us to study whether genetic variation at the CHGA locus might contribute to alterations in autonomic function, and hence hypertension and its target organ consequences such as hypertensive kidney disease (nephrosclerosis). Systematic polymorphism discovery across the human CHGA locus revealed such regulatory regions as the proximal promoter and 3`-UTR. In chromaffin cell-transfected CHGA 3`-UTR and promoter/luciferase reporter plasmids, the functional consequences of the regulatory/non-coding allelic variants were documented. Variants in both the proximal promoter and the 3`-UTR displayed statistical associations with hypertension and hypertensive end stage renal disease. Therefore, I would like to review the common genetic variation in TH and CHGA as a cause of inter-individual variation in sympathetic activity, and ultimately blood pressure and hypertensive kidney disease.

종합검진 초음파검사에서 나타난 간질환과 건강관련 요인분석

이미연(Mi-Yeon Lee) · 정홍량(Hong-Ryang Jung) · 임청환(Chang-Hwan Lim) 대한방사선과학회(구 대한방사선기술학회) 2009 방사선기술과학 Vol.32 No.1

전국 6개 도시의 종합건강검진센터에서 검진을 받은 건강한 성인 총 수진자 29,531명을 대상으로 복부초 음파검사로 진단된 간질환의 건강관련 요인을 분석한 결론은 다음과 같다. 초음파로 진단된 간질환 유병률은 43.1%로 나타났고, 성별로는 남성에서 23.3%, 여성에서 19.8%로 남성에게서 유의하게 높게 나타났으며(p < 0.001), BMI에 따른 유병률은 BMI ≥ 25인 비만 군에서 지방간만이 44.3%로 높은 유병률로 나타났으며 이는 통계적으로 유의하게 나타났다(p < 0.001). 흡연에 따른 유병률은 흡연자군에서 지방간이 49.1%(남성 22.2%, 여성 26.9%)로 가장 높게 나타났고, 통계적으로 여성에서는 유의한 차이가 있는 것으로 나타났으며(p < 0.05), 남성은 유의한 차이가 없는 것으로 나타났다(p > 0.05). 고혈압에 따른 유병률은 정상군에서 지방간이 67.7%로 가장 높은 유병률로 나타났고, 당뇨에 따른 유병률은 당뇨 군에서 전체 간질환이 높게 나타났으며 지방간이 66.2%로 가장 높게 유병률로 나타났다(p < 0.001). 간질환 유병률에 대한 다중회귀분석 결과는 연령이 증가할수록 발병가능성이 높게 나타났고, 연령, 성별, 비만도, 당뇨는 유병률과 연관성이 있게 나타났으나(p < 0.05), 고혈압과 흡연에서는 유의성이 없는 것으로 나타났다(p > 0.05). The study found out developmental factors of the liver diseases in 29,531 cases of the healthy adults who were diagnosed by using ultrasound at domestic healthcare centers in 6 cities. The results are as follows. Based on the result of the study, the liver diseases diagnosed by using ultrasound was revealed to show 43.1% of prevalence, and the occurrence was significantly higher in male (23.3%) than in female (19.8%). The prevalence of hepatic diseases related to the BMI was revealed to show highest prevalence of the fatty liver in obese group (BMI ≥ 25) by recording 44.3%. Smoking contributed to the high prevalence of all liver diseases. Although the fatty liver was the most frequently occurred form of liver diseases by recording the prevalence of 49.1% (22.2% in male, 26.9% in female), the significant difference was found only in female (p < 0.05), but male group did not show significant difference (p > 0.05). The prevalence of hepatic diseases related to the hypertension was revealed to show highest prevalence of the fatty liver in hypertension group by recording 67.7%. The prevalence of hepatic diseases related to the diabetes was revealed to show highest prevalence of the fatty liver in diabetes group by recording 66.2%. The high prevalence of all hepatic diseases was related to diabetes mellitus with statistical significance (p < 0.001). The multiple regression analysis for the related factors which affect the prevalence of the liver diseases showed the higher prevalence by age. Sex, obesity and diabetes mellitus were positively related to the prevalence (p < 0.05) while hypertension and smoking showed no significant relationship to the prevalence of the disease (p > 0.05).

Application of artificial intelligence in hypertension

조정선,Park Jae-Hyeong 대한고혈압학회 2024 Clinical Hypertension Vol.30 No.-

Hypertension is an important modifiable risk factor for morbidity and mortality associated with cardiovascular disease. The incidence of hypertension is increasing not only in Korea but also in many Western countries due to the aging of the population and the increase in unhealthy lifestyles. However, hypertension control rates remain low due to poor adherence to antihypertensive medications, low awareness of hypertension, and numerous factors that contribute to hypertension, including diet, environment, lifestyle, obesity, and genetics. Because artificial intelligence (AI) involves data-driven algorithms, AI is an asset to understanding chronic diseases that are influenced by multiple factors, such as hypertension. Although several hypertension studies using AI have been published recently, most are exploratory descriptive studies that are often difficult for clinicians to understand and have little clinical relevance. This review aims to provide a clinician-centered perspective on AI by showing recent studies on the relevance of AI for patients with hypertension. The review is organized into sections on blood pressure measurement and hypertension diagnosis, prognosis, and management. Graphical Abstract Hypertension is an important modifiable risk factor for morbidity and mortality associated with cardiovascular disease. The incidence of hypertension is increasing not only in Korea but also in many Western countries due to the aging of the population and the increase in unhealthy lifestyles. However, hypertension control rates remain low due to poor adherence to antihypertensive medications, low awareness of hypertension, and numerous factors that contribute to hypertension, including diet, environment, lifestyle, obesity, and genetics. Because artificial intelligence (AI) involves data-driven algorithms, AI is an asset to understanding chronic diseases that are influenced by multiple factors, such as hypertension. Although several hypertension studies using AI have been published recently, most are exploratory descriptive studies that are often difficult for clinicians to understand and have little clinical relevance. This review aims to provide a clinician-centered perspective on AI by showing recent studies on the relevance of AI for patients with hypertension. The review is organized into sections on blood pressure measurement and hypertension diagnosis, prognosis, and management.

Differences in prevalence of hypertension subtypes according to the 2018 Korean Society of Hypertension and 2017 American College of Cardiology/American Heart Association guidelines: The Korean National Health and Nutrition Examination Survey, 2007–2017

조소미,이호규,김현창 대한고혈압학회 2020 Clinical Hypertension Vol.26 No.1

Background: The significance of high systolic and diastolic blood pressure remains controversial. We assessed the differences in prevalence of hypertension and its subtypes according to the different hypertension diagnostic criteria embodied by the 2017 American College of Cardiology/American Heart Association (2017 ACC/AHA) and 2018 Korean Society of Hypertension (2018 KSH) guidelines. Methods: We used the 2007–2017 Korea National Health and Nutrition Examination Survey (KNHANES) data to calculate guideline-specific hypertension prevalence among untreated, adult participants. By the 2017 ACC/AHA guideline, a mean SBP ≥130 mmHg, DBP ≥80 mmHg, or currently using antihypertensive medications were considered to have hypertension. Isolated diastolic hypertension (IDH) was defined as DBP ≥80 mmHg and SBP < 130 mmHg, isolated systolic hypertension (ISH) as SBP ≥130 mmHg and DBP <80 mmHg, and systolic diastolic hypertension (SDH) as SBP ≥130 mmHg and DBP ≥80 mmHg. In a similar manner, by the 2018 KSH guideline, all hypertension and its subtype prevalence were calculated using the 140/90 mmHg cutoff. The two versions of all hypertension and its corresponding subtype prevalence were calculated among all study participants and separately by sex and age then compared via analysis of variance. Results: The prevalence of all hypertension increased from 25.9% (95% confidence interval (CI) 25.4–26.5) defined by the 2018 KSH guideline to 46.3% (95% CI 45.6–46.9) classified by the 2017 ACC/AHA guideline. Such increase was primarily manifested through substantial increase in IDH prevalence, from 5.2% (95% CI 4.9–5.4) defined by the 2018 KSH guideline to 17.9% (95% CI 17.4–18.3) defined by the 2017 ACC/AHA guideline, and was most notably observed in young age groups, 30-49 years. ISH prevalence showed minimal differences. SDH prevalence moderately increased from 3.5% (95% CI 3.3–3.7) defined by the 2018 KSH guideline to 11.1% (95% CI 10.7–11.4) defined by the 2017 ACC/AHA guideline, achieved primarily among participants aged 50 years or above. Conclusions: Changes in each subtype prevalence made differential contribution to additionally classified hypertension cases by the 2017 ACC/AHA guideline. Future studies should investigate the diastolic-associated cardiovascular risks and benefits of its long-term primary prevention in the young population.

고혈압이 있는 신장질환 환자에서 항고혈압제의 사용경험

김옥선,이연수,김보영,손혜란,윤덕심,김형규 한국병원약사회 1995 병원약사회지 Vol.12 No.1

Hypertension is a common complication of renal diseases. The prevalence of hypertension in renal diseases in about 80% chronic renal failure, 20% to 50% chronic glomerulonephritis and 40% IgA nephropathy. The factors influencing hypertension in renal diseases are an increase in total body salt and water also high plasma rennin level. Acceleration to decline the renal function is occurred in patients with high blood pressure. Therefore, optimal therapy of hypertension may be able to slow down the progression rate of renal disease. A blood pressure of less than 140/90㎜Hg has been considered to be adequate blood pressure for control. Antihypertensive effects in 45 hypertensive patients with renal diseases were evaluated before and after medication and how about the relation to progressive renal function and control to blood pressure. The results were as follows : 1. Before antihypertensive medication, serum creatinine concentration was 2.98 ±2.85㎎/㎗ and after medication 2.54±2.31㎎/㎗. 2. 66.7% patients needed less than 4 weeks to reduce below 90㎜Hg of diastolic blood pressure. 3. Frequency of antihypertensives were ACE inhibitors 93.3%, calcium channel blockers 86.7%, diuretics 55.6% and β-blockers 51.1%. 4. Combination rate of antihypertensives was 2.0±0.8.

Variation in the rate of well-controlled status of chronic disease by income level in Korea : 2010 to 2015

Choi, Kun Kug,Kim, Seung Hyuk,Yoo, Kyung Don,Kim, Hyo Jin,Park, Ji In,Hwang, Subin,Chin, Ho Jun,Ku, Ho Suk Williams & Wilkins Co 2018 Medicine Vol.97 No.34

<P><B>Abstract</B></P><P>Although it is known that the prevalence rates of chronic diseases depend on income level, annual changes of the control rate have not been evaluated. In this cross-sectional study, we analyzed the variation in rate of well-controlled status of chronic diseases based on the annual income level using data from national nutrition surveys conducted between 2010 and 2015.</P><P>Prevalence and controlled rate of hypertension, diabetes mellitus, and chronic kidney disease were analyzed in relation to annual income levels, using data from the Korea National Health and Nutrition Examination Survey (KNHANES), obtained from 2010 to 2015. We also analyzed the incidence of use of necessary medical care services and the reasons cited for not using these services.</P><P>The data of 28,759 persons were analyzed. The average age increased, and sex ratio remained unchanged over the study period. Although the prevalence rates of diabetes increased, that of increased glycated hemoglobin gradually decreased. A significant change has been shown recently on the prevalence rates of hypertension patients. The prevalence rates of chronic kidney disease stayed unchanged during the course of the study period. The incidence of controlled chronic disease status increased with the income level, and over time during the study, in the case of diabetes and chronic kidney disease. However, while controlled hypertension status rate increased from year to year, there was no trend of increase with increased income level. The incidence of participants not using hospital services declined with increasing income level, but the rate of economic causes being cited as reasons for not using hospital services increased over time and showed no change among income levels. Results of regression analysis of prevalence rates of chronic diseases by income level showed that lower income groups tended to have higher odds ratios for chronic diseases.</P><P>Our results suggest that the incidence rate of well-controlled chronic disease status remains low in lower income groups. These results imply that financial status may play an important role in the management of chronic diseases.</P>

그레이브스병에서 치료에 따른 폐동맥압의 변화

남택만,조한수,이진서,송영림,김두만,두영철,박철영,정인경,홍은경,이성진,오기원,김현규,유재명,최문기,유형준,박성우 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.5

연구배경: 갑상선기능항진증에 의한 갑상선중독증 환자들은 호흡곤란을 호소하며, 그 원인으로 호흡근의 근력 약화, 좌심실부전으로 인한 폐모세혈관의 울혈, 기도저항의 증가, 갑상선종으로 인한 기관의 압박, 호흡기능 이상 등이 거론되고 있다. 폐동맥고혈압이 동반된 그레이브스병 환자가 여러 증례가 보고되었으며, 폐동맥고혈압 환자에게서 갑상선 자가항체와 갑상선기능저하증의 빈도가 높음이 알려지면서 갑상선중독증이 동반된 그레이브스병 환자에게서 관찰되는 호흡곤란의 한 원인으로 폐동맥압 증가가 작용할 가능성이 제시되고 있다. 이에 저자 등은 그레이브스병 환자를 대상으로 폐동맥압을 측정하고 치료 전후의 폐동맥압의 변화를 전향적으로 연구하였다. 방법: 갑상선중독증이 동반된 그레이브스병 환자와 정상 갑상선기능을 나타낸 대조군을 대상으로 갑상선기능검사 및 갑상선 자가항체를 측정하고, 심초음파를 이용하여 치료 전후로 폐동맥압을 측정하여 폐동맥압과 갑상선기능 및 갑상선 자가항체와의 관계, 폐동맥압의 변화 등을 관찰하였다. 결과: 1. 연구대상은 대조군 10명 (남녀비 1:9, 관해 상태의 그레이브스병 3명, 갑상선종 3명, 정상인 4명), 그레이브스병 환자 26명 (남녀비 7:19)이었다. 2. 대조군과 치료 전 그레이브스병 환자의 폐동맥압은 각각 23.5±2.32 mmHg, 29.6±10.3 mmHg이었고, 치료 전의 폐동맥압과 혈청 갑상선자극호르몬 결합억제 면역글로불린 (TBII) 농도는 유의한 양의 상관관계를 보였다. 3. 26명의 그레이브스병 환자 중에서 10명 (38.5%)이 폐동맥고혈압 (기준: 폐동맥압 > 30 mmHg)으로 진단되었다. 4. 치료 전후로 폐동맥압을 측정한 13명은 폐동맥압이 치료 전 29.6±10.3 mmHg에서 치료 후 폐동맥압 22.2±6.48 mmHg로 의미있게 감소하였다. 결론: 갑상선중독증을 보이는 그레이브스병 환자의 약 40% 정도에서 폐동맥고혈압이 발견되어 폐동맥고 혈압은 그레이브스병에 흔하게 동반하는 질환으로 생각된다. 향후 그레이브스병 환자에서 관찰되는 폐동맥압의 증가와 관련한 병인, 발생기전 및 임상적 의의 등에 대한 연구가 필요할 것으로 생각된다. Background: Exertional symptoms, dyspnea and impaired effort tolerance are common in patients with Graves' disease. Proposed explanations include: high-output left heart failure, ineffective oxygen utilization and respiratory muscle weakness. In addition, pulmonary hypertension has also been reported in patients with Graves' disease. A high prevalence of hypothyroidism and positive thyroid autoantibody were also observed in patients with pulmonary arterial hypertension. Therefore, the pulmonary artery pressure in patients with Graves' disease was evaluated. Methods: Two-dimensional and Doppler echocardiographic examinations (Hewlett Packard Sonos 2500) were performed to determine the pulmonary artery (PA) pressure in 26 Graves' disease patients, both before and after treatment (23 patients with propylthiouracil and 3 with RAI), and in 10 euthyroid controls. The changes in the PA pressure after treatment were evaluated in 13 patients with Graves' disease, who became euthyroid after treatment. Results: The pulmonary artery pressure was increased in the untreated Graves' disease patients compared to the normal controls (23.5±2.32 vs. 29.6±10.3 mmHg). 38.5% of the Graves' disease patients (10/26) showed pulmonary arterial hypertension (PA>30 mmHg) and the serum TBII level was higher in the Graves' disease patients with pulmonary arterial hypertension than in those with normal PA pressure (P<0.05). In the Graves' patients who became euthyroid after treatment, the PA pressure was significantly decreased. Conclusion: 38.5% of the untreated Graves' disease patients showed pulmonary arterial hypertension, and the pulmonary artery pressure was significantly decreased in those who became euthyroid after treatment. The pathogenesis and clinical importance of pulmonary arterial hypertension in Graves' disease requires further studies (J Kor Soc Endocrinol 18:465∼472, 2003).

The Effect of Chronic Disease Management Program on the Risk of Complications in Patients With Hypertension in Korea

Lee Sang Ah,Park Hyeki,Kim Woorim,Song Sun Ok,Lim Hyunsun,Chun Sung-Youn 대한의학회 2022 Journal of Korean medical science Vol.37 No.31

Background: A chronic disease management program was implemented in April 2012 to lower out-of-pocket costs for repeat visits to the same clinic. The aim of this study was to investigate the association between participating in this program and the onset of complications among patients with hypertension using whole-nation claims data. Methods: We used National Health Insurance Service data (2011–2018) and patients with newly detected hypertension from 2012 to 2014 were selected. Chronic disease management program reduces the out-of-pocket expenses of consultation fee from 30% to 20% when patients enroll in this program by agreeing to visit the same clinic for the treatment of hypertension or diabetes. As the dependent variable, acute myocardial infarction (MI), stroke, chronic kidney disease (CKD), and heart failure (HF) were selected. For analysis, cox proportional hazards model was used. Results: Total participants were 827,577, among which 102,831(12.6%) subjects participated in the chronic disease management. Participants of the chronic disease management program were more likely to show lower hazard ratios (HRs) than those of non-participants in terms of all complications (MI: HR, 0.75; 95% confidence interval [CI], 0.68–0.82; stroke: HR, 0.75; 95% CI, 0.72–0.78; CKD: HR, 0.90; 95% CI, 0.85–0.96; HF: HR, 0.56; 95% CI, 0.52–0.61). Conclusion: The results showed that participants of the chronic disease management program were less likely to have hypertension complications compared to non-participants. Enhancing the participation rate may be related to better outcomes and reducing medical expenses among patients with chronic diseases.