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Disparities in Mortality and Cardiovascular Events by Income and Blood Pressure Levels Among Patients With Hypertension in South Korea

  • 주제(키워드) blood pressure , cardiovascular diseases , health status disparities , hypertension , income , mortality
  • 주제(기타) Cardiac & Cardiovascular Systems
  • 설명문(일반) [Sung, Ki-Chul] Sungkyunkwan Univ, Sch Med, Kangbuk Samsung Hosp, Div Cardiol,Dept Internal Med, 29 Saemunan Ro, Seoul 03181, South Korea; [Shin, Jeong-Hun; Kim, Woohyeun; Shin, Jinho] Hanyang Univ, Coll Med, Dept Internal Med, Div Cardiol, Seoul, South Korea; [Jung, Mi-Hyang] Hallym Univ, Dongtan Sacred Heart Hosp, Cardiovasc Ctr, Coll Med, Hwaseong, South Korea; [Kwon, Chang Hee] Konkuk Univ, Med Ctr, Dept Internal Med, Sch Med, Seoul, South Korea; [Lee, Chan Joo; Cho, Iksung; Kim, Hyeon-Chang; Park, Sungha; Kang, Seok-Min] Yonsei Univ, Dept Internal Med, Div Cardiol, Coll Med, Seoul, South Korea; [Kim, Dae-Hee] Univ Ulsan, Asan Med Ctr, Div Cardiol, Coll Med, Seoul, South Korea; [Kim, Hack-Lyoung] Seoul Natl Univ, Coll Med, Boramae Med Ctr, Dept Internal Med, Seoul, South Korea; [Kang, Si-Hyuck; Kim, Kwang Il] Seoul Natl Univ, Bundang Hosp, Dept Internal Med, Coll Med, Seongnam, South Korea; [Lee, Ju-Hee; Cho, Myeong-Chan] Chungbuk Natl Univ, Chungbuk Natl Univ Hosp, Dept Internal Med, Div Cardiol,Coll Med, Cheongju, South Korea; [Kim, Hyue Mee] Mediplex Sejong Hosp, Cardiovasc Ctr, Dept Internal Med, Div Cardiol, Incheon, South Korea; [Cho, In-Jeong; Pyun, Wook Bum] Ewha Womans Univ, Dept Internal Med, Div Cardiol, Med Ctr, Seoul, South Korea; [Lee, Jun Hyeok; Kang, Dae Ryong] Yonsei Univ, Wonju Coll Med, Ctr Biomed Data Sci, Wonju, South Korea; [Lee, Hae-Young] Seoul Natl Univ Hosp, Dept Internal Med, Div Cardiol, Seoul, South Korea; [Chung, Wook-Jin] Gachon Univ, Gil Hosp, Dept Internal Med, Div Cardiol, Incheon, South Korea; [Ihm, Sang-Hyun] Catholic Univ Korea, Bucheon St Marys Hosp, Dept Internal Med, Div Cardiol, Seoul, South Korea; [Cho, Eun Joo] Catholic Univ Korea, Yeouido St Marys Hosp, Dept Internal Med, Div Cardiol, Seoul, South Korea; [Sohn, Il-Suk] KyungHee Univ Gangdong, Dept Internal Med, Div Cardiol, Seoul, South Korea; [Kim, Ju Han] Chonnam Natl Univ Hosp, Dept Internal Med, Div Cardiol, Gwangju, South Korea; [Ryu, Sung Kee] Eulji Med Sch Med, Dept Internal Med, Div Cardiol, Seoul, South Korea
  • 등재 SCIE, SCOPUS
  • 발행기관 WILEY
  • 발행년도 2021
  • 총서유형 Journal
  • URI http://www.dcollection.net/handler/ewha/000000181552
  • 본문언어 영어
  • Published As http://dx.doi.org/10.1161/JAHA.120.018446

초록/요약

Background Socioeconomic status is associated with differences in risk factors of cardiovascular disease and increased risks of cardiovascular disease and mortality. However, it is unclear whether an association exists between cardiovascular disease and income, a common measure of socioeconomic status, among patients with hypertension. Methods and Results This population-based longitudinal study comprised 479 359 patients aged >= 19 years diagnosed with essential hypertension. Participants were categorized by income and blood pressure levels. Primary end point was all-cause and cardiovascular mortality and secondary end points were cardiovascular events, a composite of cardiovascular death, myocardial infarction, and stroke. Low income was significantly associated with high all-cause (hazard ratio [HR], 1.26; 95% CI, 1.23-1.29, lowest versus highest income) and cardiovascular mortality (HR, 1.31; 95% CI, 1.25-1.38) as well as cardiovascular events (HR, 1.07; 95% CI, 1.05-1.10) in patients with hypertension after adjusting for age, sex, systolic blood pressure, body mass index, smoking status, alcohol consumption, physical activity, fasting glucose, total cholesterol, and the use of aspirin or statins. In each blood pressure category, low-income levels were associated with high all-cause and cardiovascular mortality and cardiovascular events. The excess risks of all-cause and cardiovascular mortality and cardiovascular events associated with uncontrolled blood pressure were more prominent in the lowest income group. Conclusions Low income and uncontrolled blood pressure are associated with increased all-cause and cardiovascular mortality and cardiovascular events in patients with hypertension. These findings suggest that income is an important aspect of social determinants of health that has an impact on cardiovascular outcomes in the care of hypertension.

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