The Korean Hypertension Cohort study: design and baseline characteristics
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Background/Aims: Hypertension (HT) has a significant impact on public health and medical expenses. However, HT is a chronic disease that requires the long-term follow-up of a large number of patients. Methods: The Korean Hypertension Cohort (KHC) study aimed to develop a model for calculating cardiovascular risk in HT patients by linking and utilizing the detailed clinical and longitudinal data from hospitals and the national health insurance claim database, respectively. This cohort had a planned sample size of over 11,000 HT patients and 100,000 non-HT controls. Eligible patients were hypertensive patients, who were presenting for the first time and were diagnosed with HT as a main disease from 2006 to 2011. Long-term survival data over a period of approximately 9 years were obtained from the national health insurance claim and national health examination data. Results: This cohort enrolled 11,083 patients with HT. The mean age was 58.87 ± 11.5 years, 50.5% were male, and 31.4% were never-treated HT. Of the enrolled patients, 32.9% and 37.7% belonged to the high and moderate cardiovascular risk groups, respectively. Initial blood pressures were 149.4 ± 18.5/88.5 ± 12.5 mmHg. During the 2 years hospital data follow-up period, blood pressures lowered to 130.8 ± 14.1/78.0 ± 9.7 mmHg with 1.9 ± 1.0 tablet doses of antihypertensive medication. Cardiovascular events occurred in 7.5% of the overall patients; 8.5%, 8.8%, and 4.7% in the high, moderate, and low risk patients, respectively. Conclusions: The KHC study has provided important information on the long-term outcomes of HT patients according to the blood pressure, comorbid diseases, medication, and adherence, as well as health behaviors and health resource use.
Abstract
Background/Aims: Hypertension (HT) has a significant impact on public health and medical expenses. However, HT is a chronic disease that requires the long-term follow-up of a large number of patients. Methods: The Korean Hypertension Cohort (KHC) study aimed to develop a model for calculating cardiovascular risk in HT patients by linking and utilizing the detailed clinical and longitudinal data from hospitals and the national health insurance claim database, respectively. This cohort had a planned sample size of over 11,000 HT patients and 100,000 non-HT controls. Eligible patients were hypertensive patients, who were presenting for the first time and were diagnosed with HT as a main disease from 2006 to 2011. Long-term survival data over a period of approximately 9 years were obtained from the national health insurance claim and national health examination data. Results: This cohort enrolled 11,083 patients with HT. The mean age was 58.87 ± 11.5 years, 50.5% were male, and 31.4% were never-treated HT. Of the enrolled patients, 32.9% and 37.7% belonged to the high and moderate cardiovascular risk groups, respectively. Initial blood pressures were 149.4 ± 18.5/88.5 ± 12.5 mmHg. During the 2 years hospital data follow-up period, blood pressures lowered to 130.8 ± 14.1/78.0 ± 9.7 mmHg with 1.9 ± 1.0 tablet doses of antihypertensive medication. Cardiovascular events occurred in 7.5% of the overall patients; 8.5%, 8.8%, and 4.7% in the high, moderate, and low risk patients, respectively. Conclusions: The KHC study has provided important information on the long-term outcomes of HT patients according to the blood pressure, comorbid diseases, medication, and adherence, as well as health behaviors and health resource use.
참고문헌 (26)
- Staessen JA, "Essential hypertension", Lancet, 361, pp.1629~1641 (2003)
- Ishag Adam, "Red cell distribution width and preeclampsia: a systematic review and meta-analysis", Clinical Hypertension, 25(4), pp.16~23 (2019), 대한고혈압학회[DOI]
- Arima H, "Effects of prehypertension and hypertension subtype on cardiovascular disease in the Asia-Pacific Region", Hypertension, 59, pp.1118~1123 (2012)
- 정미향, "The effect of alcohol dose on the development of hypertension in Asian and Western men: systematic review and meta-analysis", The Korean Journal of Internal Medicine, 35(4), pp.906~916 (2020), 대한내과학회[DOI]
- Lawes CM, "Blood pressure and cardiovascular disease in the Asia Pacific region", J Hypertens, 21, pp.707~716 (2003)
- Lawes CM, "Blood pressure indices and cardiovascular disease in the Asia Pacific region : a pooled analysis", Hypertension, 42, pp.69~75 (2003)
- Whelton PK, "2017 ACC", AHA, ABC, pp.ACPM, AGS[DOI]
- Williams B, "2018 ESC", ESH guidelines for the management of arterial hypertension:the task force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. The task force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension, 2018, pp.36, 1953~2041
- Oh J, "Comparison of pooled cohort risk equations and Framingham risk score for metabolic syndrome in a Korean community-based population", Int J Cardiol, 176, pp.1154~1155 (2014)
- Chia YC, "Validation of the pooled cohort risk score in an Asian population : a retrospective cohort study", BMC Cardiovasc Disord, 14, pp.163~ (2014)
- van Dieren S, "External validation of the UK Prospective Diabetes Study(UKPDS)risk engine in patients with type 2 diabetes", Diabetologia, 54, pp.264~270 (2011)
- Hae-Young Lee, "2018 Korean Society of Hypertension Guidelines for the management of hypertension: part II-diagnosis and treatment of hypertension", Clinical Hypertension, 25(4), pp.51~74 (2019), 대한고혈압학회[DOI]
- SPRINT Research Group, "A randomized trial of intensive versus standard blood-pressure control", N Engl J Med, 373, pp.2103~2116 (2015)
- Lonn EM, "Blood-pressure lowering in intermediate-risk persons without cardiovascular disease", N Engl J Med, 374, pp.2009~2020 (2016)
- Williams B, "2018 ESC", ESH guidelines for the management of arterial hypertension, 2018, pp.39, 3021~3104
- Hsieh FY, "Sample-size calculations for the Cox proportional hazards regression model with nonbinary covariates", Control Clin Trials, 21, pp.552~560 (2000)
- Schoenfeld DA, "Sample-size formula for the proportional-hazards regression model", Biometrics, 39, pp.499~503 (1983)
- Shah SJ, "Phenomapping for novel classification of heart failure with preserved ejection fraction", Circulation, 131, pp.269~279 (2015)
- Lee JH, "Blood pressure control and cardiovascular outcomes : real-world implications of the 2017 ACC", AHA hypertension guideline, 2018, pp.8, 13155~
- Choi YJ, "Reconsidering the cutoff diastolic blood pressure for predicting cardiovascular events : a nationwide population-based study from Korea", Eur Heart J, 40, pp.724~731 (2019)
- Jeong Seon Yoo, "Predictive costs in medical care for Koreans with metabolic syndrome from 2009 to 2013 based on the National Health Insurance claims dataset", The Korean Journal of Internal Medicine, 35(4), pp.936~945 (2020), 대한내과학회[DOI]
- Der Sheng Sun, "The impact of sarcopenia on health-related quality of life in elderly people: Korean National Health and Nutrition Examination Survey", The Korean Journal of Internal Medicine, 34(4), pp.877~884 (2019), 대한내과학회[DOI]
- Seong SC, "Cohort profile : the National Health Insurance Service-National Health Screening Cohort(NHIS-HEALS)in Korea", BMJ Open, 7, pp.e016640~ (2017)
- Leopold JA, "Emerging role of precision medicine in cardiovascular disease", Circ Res, 122, pp.1302~1315 (2018)
- Choi KH, "Persistence with antihypertensives in uncomplicated treatment-naïve very elderly patients : a nationwide population-based study", BMC Cardiovasc Disord, 17, pp.232~ (2017)
- Cho IJ, "Incremental value of repeated risk factor measurements for cardiovascular disease prediction in middle-aged Korean adults : results from the NHIS-HEALS(National Health Insurance System-National Health Screening Cohort)", Circ Cardiovasc Qual Outcomes, 10, pp.e004197~ (2017)
