Prehypertension

홍경순 대한심장학회 2008 Korean Circulation Journal Vol.38 No.1

The Seventh Report of the Joint National Committee (JNC-7) introduced a new term "prehypertension" and it broadened the range of prehypertension to 120-139/80-89 mmHg. It is estimated that 31% of the US population and 29% of the Korean population have prehypertension. This condition is very prevalent and it's associated with other cardiovascular risk factors, especially obesity and diabetes. These people are at high risk for developing hypertension and subsequent cardiovascular events. Therefore, prehypertension has become a major public health concern, but the treatment standards have not yet been established. The JNC-7 report has recommended healthy lifestyles for all the people with prehypertension and it especially advocated drug treatment for the group of people with diabetes or chronic renal disease. This article reviews the prevalence of prehypertension, the risk and rate of progression to hypertension, the associated cardiovascular disease, the adverse cardiovascular events and the current status of treatment. (Korean Circ J 2008;38:1-6)

Association of Serum γ-Glutamyltransferase Level and Incident Prehypertension in Korean Men

천혜진,박성근,류재홍 대한의학회 2013 Journal of Korean medical science Vol.28 No.11

Several lines of evidence indicate that prehypertension is more atherogenic than normal blood pressure. Serum γ-glutamyltransferase (GGT) is known to be positively associated with prehypertensive status and the progression of hypertension. However, there have been no prospective studies of serum GGT level as a predictor of prehypertension. Apparently 13,435 healthy men (mean age 42.0±6.6 yr) with normal blood pressure were included in a prospective cohort study in 2005 and were followed up to 2010 with the endpoint being incident of prehypertension. During the follow up period (median 2.80± 1.44 yr; actual follow-up 37,679.1 person-year), prehypertension was developed in 7,867 (58.6%) participants. Risk estimations for incident prehypertension were analyzed based on quartiles of serum GGT levels using multivariate adjusted Cox proportional hazards model. In unadjusted model, the hazard ratio for incident prehypertension for the highest 3 quartiles of baseline serum GGT level was 1.21 (1.13-1.29), 1.29 (1.21-1.38), and 1.57 (1.47-1.67) compared the lowest quartile of serum GGT level, respectively (P for trend< 0.001). These associations still remained statistically significant, even after adjusting for multiple covariates. These findings indicate that increased serum GGT level is independently associated with incident prehypertension in Korean men.

한국 성인의 혈청 비타민 D와 당뇨병 전단계 및 고혈압 전단계와의 관련성: 2013–2015년 국민건강영양조사 자료 분석결과

박지순,남가은,추지민,박희웅,이상조,박신욱,정선주,이은식,허연,김원석,권영근,김양현,조경환 대한가정의학회 2020 Korean Journal of Family Practice Vol.10 No.2

Background: Recent studies have indicated that vitamin D deficiency is associated with diabetes and hypertension in adults. However, this associationhas not been sufficiently studied in cases of prediabetes and prehypertension. Thus, this study aimed to clarify the relationship between vitamin Dlevels and prediabetes and prehypertension in Korean adults. Methods: Data from 1,808 adults aged ≥19 years who participated in the 2013–2015 Korea National Health and Nutrition Examination Survey wereincluded in this study. The odds ratio of prediabetes and prehypertension according to the 25-hydroxyvitamin D (25[OH]D) status was calculatedusing multivariable logistic regression analysis. Results: Mean serum 25(OH)D levels were significantly different among females with normal glucose levels, prediabetes, and diabetes mellitus. Further,the mean levels were not significantly different in both males and females of all ages with normal blood pressure, prehypertension, andhypertension. In addition, logistic regression analysis showed that serum 25(OH)D levels were not significantly associated with the odds ratio ofprediabetes and prehypertension after adjusting for age, sex, smoking, alcohol consumption, physical activity, calcium supplement intake, income,body mass index, systolic blood pressure, and fasting glucose. Conclusion: Serum vitamin D status was not independently associated with the risks of prediabetes and prehypertension in Korean adults. 연구배경: 현재 전세계적으로 성인에서는 비타민 D 결핍이 당뇨병및 고혈압과 관련 있다는 여러 연구들이 보고되고 있으나 한국인을대상으로 비타민 D와 당뇨병 전단계 및 고혈압 전단계와의 관련성을 살펴본 연구는 부족한 실정이다. 본 연구는 국민건강영양조사자료를 이용하여 19세 이상 한국 성인에서 혈중 비타민 D 상태와당뇨병 전단계 및 고혈압 전단계 간의 관련성을 알아보고자 하였다. 방법: 2013–2015년 국민건강영양조사에 참여한 19세 이상 성인 총1,808명(남자 853명, 여자 955명)을 연구대상자로 하였다. 비타민 D의 상태에 따른 당뇨병 전단계와 고혈압 전단계의 상관성을 확인하기 위해 혈중 25-hydroxivitamin D (25[OH]D) 농도를 독립변수로 하였고 당뇨병, 당뇨병 전단계, 고혈압, 고혈압 전단계를 종속변수로설정하여 다변량로지스틱 회귀분석을 실시하였다. 결과: 청년, 중장년, 노년 및 남성에서 당뇨병, 당뇨병 전단계, 정상혈당군에 따른 25(OH)D의 평균값은 유의한 차이를 보이지 않았으나, 여성의 경우 유의한 차이를 보였다(P=0.01). 또한 25(OH)D의 평균값을 고혈압, 고혈압 전단계, 정상 혈압군에 따라 비교한 결과 각연령 및 성별군에서 유의한 차이를 보이지 않았다. 또한, 연령, 성별,흡연, 알코올 섭취, 신체 활동, 칼슘 보충제 섭취, 소득수준, 체질량지수, 수축기 혈압, 공복혈당을 보정한 후 혈중 25(OH)D 상태는 당뇨병 전단계 및 고혈압 전단계의 오즈비와 유의한 관련성이 없는 것으로 나타났다. 결론: 한국 성인에서 혈중 비타민 D 상태는 당뇨병 전단계와 고혈압 전단계의 위험과 독립적인 관련성을 보이지 않았다.

Clinical Significance of Non-Alcoholic Fatty Liver Disease as a Risk Factor for Prehypertension

류재홍,함우택,최중명,강민아,안소희,이종근,신호철,박성근 대한의학회 2014 Journal of Korean medical science Vol.29 No.7

Previous epidemiologic studies have shown the clinical association between non-alcoholicfatty liver disease (NAFLD) and cardiovascular disease (CVD). However, there is only limitedinformation about the effect of NAFLD on the development of hypertension. Accordingly,we investigated the clinical association between NAFLD and prehypertension. A prospectivecohort study was conducted on the 11,350 Korean men without prehypertension for 5 yr. The incidences of prehypertension were evaluated, and Cox proportional hazard model wasused to measure the hazard ratios (HRs) for the development of prehypertension accordingto the degree of NAFLD (normal, mild, moderate to severe). The incidence of prehypertensionincreased according to NAFLD states (normal: 55.5%, mild: 63.7%, moderate to severe:70.3%, P < 0.001). Even after adjusting for multiple covariates, the HRs (95% confidenceinterval) for prehypertension were higher in the mild group (1.18; 1.07-1.31) and moderateto severe group (1.62; 1.21-2.17), compared to normal group, respectively (P for trend< 0.001). The development of prehypertension is more potentially associated with themore progressive NAFLD than normal and milder state. These findings suggest the clinicalsignificance of NAFLD as one of risk factors for prehypertension.

경계성고혈압자들의 유산소운동에 따른 심혈관 반응에 관한 연구

최현민(Choi Hyun-Min),노호성(Nho Ho-Sung),김종경(Kim Jong-Kyung) 한국체육과학회 2009 한국체육과학회지 Vol.18 No.2

It was suggested that the exercise pressor reflex(EPR) plays an important role in the cardiovascular responses to aerobic exercise and in animal experiment EPR function was altered and exaggerated cardiovascular response to passive stretch in hypertensive rats. But it is not reported that the exaggerated cardiovascular response to exercise is mediated by EPR overactivity in prehypertensive people. Therefore, this study was to compare the physiological responses between normotensive and prehypertension during aerobic exercise. Nine normotensive subjects and ten subjects with prehypertension in being university were recruited for this study. All subjects were continuously instrumented to measure stroke volume, heart rate, cardiac output, total vascular conductance, and blood pressure with increasing workloads (low, mid, high intensity). The results showed that systolic blood pressure, diastolic blood pressure, mean arterial pressure significantly increased in both groups with increasing workloads, but there was significantly higher in subjects with prehypertension. There were no differences in heart rate, stroke volume, and total vascular conductance between both groups with increasing exercise intensity. Cardiac output was significantly higher in subjects with prehypertension at rest. This study suggests that there was an exercise blood pressure responses in people with prehypertension of essential blood pressure during aerobic exercise and there may be higher risk of future hypertension development.

고혈압전단계자에 대한 유산소운동이 심혈관반응에 미치는 영향

홍선주(Sun Joo Hong),김종경(Jong Kyung Kim),최현민(Hyun Min Choi),박시영(Si Young Park),이준희(Joon Hee Lee),전종목(Jong Mok Chun),노호성(Ho Sung Nho) 한국사회체육학회 2010 한국사회체육학회지 Vol.0 No.42

It is generally known that in hypertensive individuals, exercise induces exaggerated increase in arterial blood pressure and in turn this dangerous elevation may increase the risks for myocardial infarction, cardiac arrest, or stroke. However, it has still not been investigated whether the exaggerated cardiovascular responses occur in prehypertension and these excessive responses are mediated by exercise pressor reflex overactivity. Therefore, the purpose of this study was to examine the effects of exercise pressor reflex on the cardiovascular responses when exercise intensity increased from rest through low exercise intensity to high exercise intensity. Twenty young, fit people (10 normotension and 10 prehypertension) with normal body fat percentage were recruited for this study. All subjects were instrumented to measure the cardiovascular responses at rest and during exercise. A catheter to collect blood samples was inserted into left brachial vein. Systolic blood pressure, diastolic blood pressure, and mean arterial blood pressure were significantly higher in prehypertension across workloads compared to the normotension. Stroke volume (SV), heart rate (HR), and cardiac output (CO) were significantly increased in both groups with increasing workloads, but SV and CO were significantly higher in prehypertension. There was no difference in total vascular conductance in both groups. Thus, exaggerated blood pressure responses were mediated via increases in CO. This study suggests that the excessive cardiovascular responses to exercise in prehypertension may be due to dysfunction of exercise pressor reflex.

고혈압 전단계 성인의 비만 인체측정지수가 고혈압 발생 위험에 미치는 영향: 코호트 연구를 활용한 이차분석

장세영(Jang, Se Young),김지훈(Kim, Jihun),김선화(Kim, Seonhwa),이은선(Lee, Eun Sun),최은정(Choi, Eun Jeong) 한국간호과학회 2024 Journal of Korean Academy of Nursing Vol.54 No.1

Purpose: This study aimed to investigate the impact of anthropometric indices of obesity (body mass index [BMI], waist circumference, waist hip ratio, and body fat percentage) on the incidence of hypertension in adults with prehypertension. Methods: A longitudinal study design using secondary data form the Korean Genome and Epidemiology Study was employed. The study included 1,838 adults with prehypertension tracked every two years from 2001 to 2018. Statistical analyses, including frequency assessments, number of cases per 1,000 person-years, log-rank tests, Kaplan-Meier curves, and Cox’s proportional hazards regression, were conducted using SPSS version 25. Results: Over the observation period (15,783.6 person-years), 1,136 individuals developed hypertension. The incidence of hypertension was significantly higher in the obesity groups defined by BMI (hazard ratio [HR] = 1.33), waist circumference (HR = 1.34), waist hip ratio (HR = 1.29), and body fat percentage (HR = 1.31) compared to the non-obese group. These findings indicate an increased risk of hypertension associated with obesity as measured by these indices. Conclusion: The study underscores the importance of avoiding obesity to prevent hypertension in individuals with prehypertension. Specifically, BMI, waist circumference, waist hip circumference, and body fat percentage were identified as significant risk factors for hypertension. The results suggest the need for individualized weight control interventions, emphasizing the role of health professionals in addressing the heightened hypertension risk in this population.

해군 정비창 작업장에서의 만성병 유병률 조사

박선균 ( Sun-kyun Park ),홍순억 ( Soon-auck Hong ) 국군의무사령부 2013 대한군진의학학술지 Vol.44 No.1

Objective : This study was performed to investigate the prevalence of hypertension and diabetes in naval ship repairing shop. Method : The study was conducted from March, 2012 to July, 2012, and total study participants were 1,260 male workers. To compare with general population in Korea, data from the Korean National Health and Nutrition Survey in 2010 were used and analysed together. Results : Among subjects with age ≥ 30 years, the age-standardized prevalences of prehypertension, hypertension, prediabetes, and diabetes were 52.9 % (95 % C.I. 50.1-55.7), 25.1 % (95 % C.I. 22.6-27.5), 23.9 % (95 % C.I. 21.5-26.3), and 6.7 % (95 % C.I. 5.3-8.1), respectively. Generally, age-specific prevalences of hypertensive and diabetic states were increasing as age increased except for prehypertension. Conclusion : The results show that the prevalence of prehypertension is more than a half in the subjects. The republic of Korea Navy should concentrate to improve awareness and control of prehypertension.

Prevalence and characteristics of isolated nocturnal hypertension in the general population

( Moo-yong Rhee ),( Je Sang Kim ),( Chee Hae Kim ),( Ji-hyun Kim ),( Jung-ha Lee ),( Sun-woong Kim ),( Deuk-young Nah ),( Namyi Gu ),( Eun-joo Cho ),( Ki-chul Sung ),( Kyung-soon Hong ) 대한내과학회 2021 The Korean Journal of Internal Medicine Vol.36 No.5

Background/Aims: Ascertaining the prevalence of isolated nocturnal hypertension (INHT) in the general population and identifying the characteristics of patients with INHT may be important to determine patients who should receive 24- hour ambulatory blood pressure (BP) measurements. This study aimed to evaluate the prevalence and characteristics of INHT in the general population. Methods: Of 1,128 participants (aged 20 to 70 years), we analyzed 823 who had valid 24-hour ambulatory BP measurements and were not on antihypertensive drug treatment. Results: The prevalence of INHT in the study was 22.8%. Individuals with INHT had a higher office, 24-hour, and daytime and nighttime ambulatory systolic and diastolic BPs compared to individuals with sustained day-night normotension. INHT was more prevalent in individuals with masked hypertension (MH) than in those with sustained hypertension (59.8% vs. 15.6%, p < 0.001). Among individuals with INHT, 92.6% had MH. Among individuals with office BP-based prehypertension, 34.5% had both INHT and MH. The prevalence of INHT was highest in individuals with office BP-based prehypertension. INHT was an independent determinant of MH after adjustment for age, sex, body mass index, diabetes, low-density-lipoprotein cholesterol, 24-hour systolic and diastolic BP, systolic and diastolic BP dipping, and systolic and diastolic BP non-dipping. Conclusions: The present study showed that INHT is not uncommon and is a major determinant of MH. Our findings strongly suggest the use of 24-hour ambulatory BP measurement for individuals within the prehypertension range of office BP owing to the high prevalence of INHT and MH in this population.

고혈압 전단계 및 고위험군 관리의 과학적 근거

천병렬,신지연 대한의사협회 2011 대한의사협회지 Vol.54 No.10

The establishment of the concept of “prehypertension” has drawn attention to the preclinical range of blood pressure with clinical and public health significance. Prehypertensive individuals require lifestyle modifications (risk factor management) to prevent the progressive rise in blood pressure and cardiovascular diseases (CVDs). Also, for those with hypertension, adoption of healthy lifestyles is an indispensable part of hypertension control, because lifestyle modifications enhance antihypertensive drug efficacy and prevent or delay the incidence of CVD. For the effective management of hypertension at the national level in Korea, evidence-based recommendations for lifestyle modification method and education programs are urgently needed. Thus, to obtain evidence-based data, intensive support from the government level is needed for further long-term follow-up studies and randomized clinical trials for high-risk groups and prehypertensives.