BACKGROUND: High blood pressure is prevalent in obesity and diabetes, especially noninsulin dependent diabetes mellitus, and both conditions are insulin resistant state. METHOD: To test whether resistance to insulin-stimulated glucose uptake and hyperinsulinemia are involved in the pochogenesis of hypertension, author measured glucose, insulin and C-Peptide reponse after oral glucose loading in 52 cases of essential hypertension and 62 cases of normal controls who had been admitted to the ward of internal medicine, Pusan National University Hospita. RESULTS: Basal plasma glucose, insulin and C-Peptide levels in control subjects were 92.1+/-36.8mg/dl, 8.7+/-5.5microu/ml and 2.2+/-1.8ng/ml and in hypertensive subjects were 95.7+/-32.6mg/dl, 12.2+/-5.3microu/ml and 2.9+/-1.6ng/ml. The basal insulin level was markedly higher than tat of control subjets (p<0.05). The basal glucose and C-Peptide levels in hypertensive patioents were higher than controls but statistically not significant. Plasma glucose levels in time course after glucose load in hypertensive patients showed significantly higher levels in 60,90minutes than controls. Plasma insulin levels in hypertensives in 90 minutes were significantly higher. The C-Peptide levels in hypertensives showed significantly higher in each times 30,60,90,120 minutes than controls. In hypertensive patients, body weight, blood pressure levels and duration of hypertension were not significantly correlated with responses of glucose, insalin and c-peptioce. Hypertensive patients aboce the age of 50 showed significantly higher glucose levels in 60,90,120 minutes than under age of 50. CONCLUSION: These results indicate some tendency of disturbed glucose turnover or insulin-resistant state in essential hypertension. This metabolic disturbance in essential hypertension should be considered in the management of hypertensive patients.
Blood Glucose* ; Blood Pressure ; Body Weight ; Busan ; C-Peptide* ; Diabetes Mellitus ; Glucose ; Humans ; Hyperinsulinism ; Hypertension* ; Insulin Resistance ; Insulin* ; Internal Medicine ; Obesity ; Plasma*

This paper aims to make a step-by-step strategy to formulate an unified health system by clarifying and overcoming challenges facing South and North Korea and to estimate costs needed for South Korea to assist North Korea to recover to normal health delivery system. We explored implications through literature review and estimated costs under the assumption that supportive activities be provided for 5 years in three ways: support for the development of health and medical care manpower; support for health and medical facilities; and support for the provision of both preventive and primary health care. Step-by-step strategy is formulated for a unified health system with the cost estimation resulting as follows: in case of basic scenario, a total of 3 trillion and 341 billion won (at present value of the year 2017) is in need for the 5-year period at the initial ‘recovery support stage’ with 135.9 billion won for the development of health and medical care manpower, approximately 2 trillion won for health and medical facilities, and 1.2 trillion won for the provision of both preventive and primary health care. Step-by-step approach is more realistic and applicable in formulating unified health system. Suggested stages are ‘recovery support stage,’ ‘system homogenization stage,’ and ‘unified system stage.’ Strategies at ‘recovery support stage’ suggested in this paper need to be pursued and followed by those at ‘system homogenization stage’ and ‘unified system stage.’
Democratic People's Republic of Korea ; Korea ; Primary Health Care

This road map aims to establish a stable and integrated healthcare system for the Korean Peninsula by improving health conditions and building a foundation for healthcare in North Korea through a series of effective healthcare programs. With a basic time frame extending from the present in stages towards unification, the roadmap is composed of four successive phases. The first and second phases, each expected to last five years, respectively, focus on disease treatment and nutritional treatment. These phases would thereby safeguard the health of the most vulnerable populations in North Korea, while fulfilling the basic health needs of other groups by modernizing existing medical facilities. Based on the gains of the first two phases, the third phase, for ten years, would prepare for unification of the Koreas by promoting the health of all the North Korean people and improving basic infrastructural elements such as health workforce capacity and medical institutions. The fourth phase, assuming that unification will take place, provides fundamental principles and directions for establishing an integrated healthcare system across the Korean Peninsula. We are hoping to increase the consistency of the program and overcome several existing concerns of the current program with this roadmap.
Delivery of Health Care/methods/*organization & administration/standards ; Health Care Sector ; Health Manpower ; Humans ; Nutrition Assessment ; Republic of Korea