Stroke is one of the leading causes of death in Korea. According to the report from Korean national statistical office, the mortality rate of stroke was 73.2/100,000 persons in 2000. In Western countries, stroke mortality rates declined gradually from 1970, which accelerated markedly around 1990. Since then, there has been no further decrease in stroke mortality rates until now and the situation has been similar in Korea. In the past, hemorrhagic stroke in Korea similar to other Far East Asian countries. However, the ratio of hemorrhagic to ischemic stroke has been reversed since mid-1980s. This trend might be due to the westernization of diet and life style as well as better control of hypertension. The case fatality rate from one of the large hospital-based stroke registry was 7.2% within 30 days after the onset of acute ischemic stroke, which is similar to those of other series from western countries with an advanced medical care systems. It may be attributed to the inclusion of more asymptomatic or milder patients with small lesions detected by neuroimaging. Importantly, the delay of hospital visit after the onset of stroke and the lower compliance for secondary prevention remain serious problems in managing acute stroke in Korea. Despite recent advances in the diagnosis and management of stroke, there has not been a nationwide population-based epidemiologic data on stroke in Korea. Therefore the application of Internet technology to develop multi center cooperative hospital-based registry could be an important step toward a long-waited nationwide stroke registry.
Asian Continental Ancestry Group ; Cause of Death ; Compliance ; Diagnosis ; Diet ; Epidemiology* ; Far East ; Humans ; Hypertension ; Internet ; Korea* ; Life Style ; Mortality ; Neuroimaging ; Secondary Prevention ; Stroke*

OBJECTIVES: Controlling blood pressure is a key step in reducing cardiovascular mortality in older adults. Gender differences in patients' attitudes after disease diagnosis and their management of the disease have been identified. However, it is unclear whether gender differences exist in hypertension management among older adults. We hypothesized that gender differences would exist among factors associated with hypertension diagnosis and control among community-dwelling, older adults. METHODS: This cross-sectional study analyzed data from 653 Koreans aged > or =60 years who participated in the Korean Social Life, Health, and Aging Project. Multiple logistic regression was used to compare several variables between undiagnosed and diagnosed hypertension, and between uncontrolled and controlled hypertension. RESULTS: Diabetes was more prevalent in men and women who had uncontrolled hypertension than those with controlled hypertension or undiagnosed hypertension. High body mass index was significantly associated with uncontrolled hypertension only in men. Multiple logistic regression analysis indicated that in women, awareness of one's blood pressure level (odds ratio [OR], 2.86; p=0.003) and the number of blood pressure checkups over the previous year (OR, 1.06; p=0.011) might influence the likelihood of being diagnosed with hypertension. More highly educated women were more likely to have controlled hypertension than non-educated women (OR, 5.23; p=0.013). CONCLUSIONS: This study suggests that gender differences exist among factors associated with hypertension diagnosis and control in the study population of community-dwelling, older adults. Education-based health promotion strategies for hypertension control might be more effective in elderly women than in elderly men. Gender-specific approaches may be required to effectively control hypertension among older adults.
Aged ; *Aging ; Asian Continental Ancestry Group ; Awareness ; Blood Pressure ; Body Mass Index ; Cross-Sectional Studies ; Female ; *Health Status ; Humans ; Hypertension/diagnosis/epidemiology/*prevention & control ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Republic of Korea/epidemiology ; Sex Factors

INTRODUCTIONHypertension is a common chronic condition usually managed by primary-care practitioners in Singapore. This study assessed the characteristics, control and complications of non-diabetic hypertensive patients managed at government primary healthcare clinics.

MATERIALS AND METHODSA cross-sectional study involving 9 clinics was conducted over 1-week in 2006. Five hundred and six non-diabetic hypertensive patients were systematically sampled from all clinic attendees. Data relating to socio-demographic, lifestyle factors, treatment and complications were collected by interviewer-administered questionnaires and review of clinic medical records. Blood pressure (BP) measurements were taken with validated automated sets following a standard protocol.

RESULTSThe prevalence of good BP control (<140/90 mmHg) was 37.7% (95% CI: 33.6% to 41.8%). Ninety seven percent were on medication with about half on monotherapy. Seventy percent of patients had a body mass index (BMI) of 23.0 kg/m(2) or higher, 64% did not exercise regularly and 8% were current smokers. After adjusting for age and lifestyle factors, male hypertensive patients had poorer BP control compared to females. Nineteen percent of patients reported at least 1 complication of hypertension, especially cardiac disease. After multivariate analysis and duration of disease, age and the male gender were associated with the presence of hypertensive complications.

CONCLUSIONSMore than half of the patients were not controlled to target levels. Male patients were more likely to have poorer control of hypertension and significantly higher risks of complications. Control of BP could be further improved by lifestyle modifications - weight reduction, promotion of physical activity, healthier eating habits and smoking cessation.

Aged ; Blood Pressure ; Body Mass Index ; Community-Based Participatory Research ; Confidence Intervals ; Cross-Sectional Studies ; Diet, Reducing ; Female ; Humans ; Hypertension ; complications ; diagnosis ; epidemiology ; prevention & control ; Life Style ; Male ; Middle Aged ; Motor Activity ; Multivariate Analysis ; Prevalence ; Primary Health Care ; statistics & numerical data ; Risk ; Sex Factors ; Singapore ; epidemiology ; Surveys and Questionnaires ; Weight Loss