A Comparison of Predictability of Physician-Diagnosed Hypertension according to Major Cardiovascular Disease Risk Factors: A Nationwide Population-Based Retrospective Cohort Study

초록

Background: Cardiovascular disease risk factors are known to be predictors of type 2 diabetes and coronary events. We hypothesized that they may also predict hypertension. We aimed to evaluate the relationship between cardiovascular disease risk factors and development of hypertension, using retrospective cohort data. Methods: This study used retrospective cohort data from the National Health Insurance Service in Korea. A total of 125,318 Korean adults over 30 years old, without pre-existing hypertension at baseline, were followed from 2009 to 2013. The prevalence of hypertension and cardiovascular disease risk factors, including central obesity, abnormal fasting glucose, and dyslipidemia, was assessed. Results: During the median follow-up time of 3.9 years, 9,019 of the 125,318 subjects who were normotensive at baseline developed hypertension: 5,059 men and 3,960 women. The development of hypertension was examined by person-year (generating a population prevalence per 100 persons during a year), and by hazard ratio (HR). A significant increase was observed based on the number of metabolic syndrome components (P<0.001): elevated blood glucose (HR, 1.66), dyslipidemia (HR, 1.30), and large waist circumference (HR, 1.11); number of component 0: HR, 1; 1: HR, 1.28; 2: HR, 1.58; 3: HR, 2.05. After adjustment for age, sex, body mass index, smoking status, alcohol intake, and physical activity, elevated blood glucose has a more significant predictive value than any other metabolic syndrome component (HR, 1.66; 95% confidence interval, 1.56–1.77). Conclusion: Metabolic syndrome amplifies hypertension development. Among the metabolic syndrome components, elevated blood glucose is the most powerful predictor for the development of hypertension.

키워드