BACKGROUND: There is little published evidence about the role of non-alcoholic fatty liver disease (NAFLD) in the progression from prehypertension to hypertension. This study was conducted to investigate the association of NAFLD and its severity with the risk of hypertension developing from prehypertension. METHODS: The study cohort comprised 25,433 participants from the Kailuan study with prehypertension at baseline; those with excessive alcohol consumption and other liver diseases were excluded. NAFLD was diagnosed by ultrasonography and stratified as mild, moderate, or severe. Univariable and multivariable Cox proportional hazard regression was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of incident hypertension according to the presence and 3 categories of severity of NAFLD. RESULTS: During a median of 12.6 years of follow-up, 10,638 participants progressed to hypertension from prehypertension. After adjusting for multiple risk factors, patients with prehypertension and NAFLD had a 15% higher risk of incident hypertension than those without NAFLD (HR = 1.15, 95% CI 1.10-1.21). Moreover, the severity of NAFLD was associated with the incidence of hypertension, which was higher in patients with more severe NAFLD (HR = 1.15 [95% CI 1.10-1.21] in the mild NAFLD group; HR = 1.15 [95% CI 1.07-1.24] in the moderate NAFLD group; and HR = 1.20 [95% CI 1.03-1.41] in the severe NAFLD group). Subgroup analysis indicated that age and baseline systolic blood pressure may modify this association. CONCLUSIONS NAFLD is an independent risk factor for hypertension in patients with prehypertension. The risk of incident hypertension increases with the severity of NAFLD.
Humans ; Non-alcoholic Fatty Liver Disease/complications* ; Prehypertension/diagnosis* ; Risk Factors ; Hypertension ; Incidence

Hypertension is the most important risk factor for cardiovascular disease-related deaths among urban and rural residents, and it has become a significant global public health issue. In October 2022, the Clinical Practice Guidelines for the Management of Hypertension in China(hereinafter referred to as the Practice Guidelines) were jointly released by the National Cardiovascular Center and other academic organizations. The Practice Guidelines sparked extensive discussions as they clearly lowered the diagnostic criteria for hypertension, raised the blood pressure targets for elderly patients, and proposed changes in the timing of early medication intervention. While these adjustments have some international evidence-based support, there is still debate regarding the cardiovascular benefits of intensified blood pressure control based on the existing level of evidence. Furthermore, whether the series of new standards proposed in the Practice Guidelines are suitable for the Chinese population and whether the hypertension control level in primary care in China can adapt to the new diagnostic and treatment standards require further in-depth research. In contrast to the strict blood pressure control concept emphasized in the Practice Guidelines, traditional Chinese medicine(TCM) emphasizes the concept of comprehensive prevention and treatment and holistic therapy in the treatment of hypertension, including prehypertension, hypertension, and target organ damage. In recent years, based on abundant clinical trial research and high-quality evidence-based support, the advantages of TCM in treating hypertension have gradually emerged. Previous studies by this research team have found that the pathogenesis of hypertension includes three major types: fire syndrome, fluid retention syndrome, and deficiency syndrome. TCM treatment of hypertension features stable blood pressure reduction, gentle blood pressure lowering, and long-lasting effects. In addition to blood pressure reduction, it also has effects such as reversing risk factors and protecting target organ damage. It demonstrates the characteristics of multiple targets, multiple components, and comprehensive regulation, and can be applied throughout the entire process of prevention and treatment, including prehypertension, hypertension, and target organ damage in the early, middle, and late stages of hypertension. Therefore, it has certain clinical application prospects.
Aged ; Humans ; Antihypertensive Agents/therapeutic use* ; China ; Hypertension/drug therapy* ; Medicine, Chinese Traditional ; Prehypertension/drug therapy* ; Practice Guidelines as Topic

Objective: To estimate the prevalence, awareness, treatment and control rate of hypertension among young and middle-aged population in China. Methods: The analysis was based on the results of 2012-2015 China Hypertension Survey, which was a cross-sectional stratified multistage random sampling survey. A total of 229 593 subjects were included in the final analysis. The data including sex, age, living in urban and rural areas, prevalence of hypertension, history of stroke, family history of coronary heart disease and drinking, physical examination, heart rate were collected. Hypertension was defined as mean systolic blood pressure (SBP) ≥140 mmHg (1 mmHg=0.133 kPa), and (or) diastolic blood pressure (DBP) ≥90 mmHg, and (or) self-report a history of hypertension, and (or) use of antihypertensive medicine within 2 weeks before survey. Prehypertension was defined as SBP between 120-139 mmHg, and (or) DBP between 80-89 mmHg. Control of hypertension was considered for hypertensive individuals with SBP<140 mmHg and DBP<90 mmHg. The prevalence of prehypertension, hypertension, awareness, treatment, control rate were calculated, and the control rate among those with antihypertensive medication was also calculated. Results: The prevalence of prehypertension and hypertension was 43.8% (95%CI: 42.3%-45.4%), and 22.1% (95%CI: 20.8%-23.3%), respectively. The prevalence of prehypertension and hypertension was significantly higher among male than female across different age groups. The awareness, treatment, control rate of hypertension and control rate among treated hypertensive participants were 43.8%, 33.2%, 16.7%, and 40.2%, respectively. The prevalence was higher, and the control rate was lower among individuals with higher heart rate. Conclusion: The prevalence of prehypertension and hypertension among young and middle-aged population is high, the awareness, treatment and control rate need to be further improved in this population. The prevention and treatment of hypertension should be strengthened in the future to improve the control rate of hypertension in China.
Middle Aged ; Male ; Female ; Humans ; Antihypertensive Agents/therapeutic use* ; Prehypertension/epidemiology* ; Prevalence ; Cross-Sectional Studies ; Hypertension/drug therapy* ; Blood Pressure ; China/epidemiology*

The aim in this literature review was (1) to explore the physiologically and psychologically therapeutic benefits of forest bathing on adults suffering from pre-hypertension or hypertension, and (2) to identify the type, duration, and frequency of an effective forest bathing intervention in the management of pre-hypertension and hypertension, so as to provide directions for future interventions or research. The electronic databases PubMed, Cochrane Library, CINAHL, PsyINFO, and the China Academic Journals (CAJ) offered through the Full-text Database (CNKI) were searched for relevant studies published from the inception of the databases to April 2019. Of the 364 articles that were identified, 14 met the criteria for inclusion in this review. The synthesis of the findings in the included studies revealed that forest bathing interventions were effective at reducing blood pressure, lowering pulse rate, increasing the power of heart rate variability (HRV), improving cardiac-pulmonary parameters, and metabolic function, inducing a positive mood, reducing anxiety levels, and improving the quality of life of pre-hypertensive or hypertensive participants. Forest walking and forest therapy programs were the two most effective forest bathing interventions. Studies reported that practicing a single forest walking or forest therapy program can produce short-term physiological and psychological benefits. It is concluded that forest bathing, particularly forest walking and therapy, has physiologically and psychologically relaxing effects on middle-aged and elderly people with pre-hypertension and hypertension.
Adult ; Aged ; Aged, 80 and over ; Female ; Forests ; Humans ; Hypertension ; prevention & control ; Male ; Middle Aged ; Prehypertension ; prevention & control ; Relaxation Therapy ; statistics & numerical data ; Young Adult

prehypertension and hypertension combined in a cross-sectional study of the Filipino Women's Diet and Health Study (FiLWHEL).SUBJECTS/METHODS: This study included a total of 428 women aged 20–57 years who have ever been married to Korean men. Prehypertension was defined as 120 - < 140 mmHg of SBP or 80 - < 90 mmHg of DBP and hypertension as SBP ≥ 140 mmHg or DBP ≥ 90 mmHg. Fried food intake was assessed using one-day 24-hour recall. Fried foods were categorized into total, deep/shallow and pan/stir fried foods. The odds ratio (OR)s and 95% confidence interval (CI)s were calculated using multivariate logistic regression.RESULTS: The prevalence of prehypertension and hypertension combined was 41.36% in this population. High fried food intake was associated with high prevalence of prehypertension and hypertension combined. The odds of having prehypertension and hypertension was higher in the 3rd tertile of fried food intake among fried food consumers compared to non-fried food consumers (OR = 2.46, 95% CI = 1.24, 4.87; P for trend = 0.004). Separate analysis for types of frying showed that deep and shallow fried food intake was associated with prevalence of prehypertension and hypertension combined for comparing the 3rd tertile vs. non-fried food consumers (OR = 2.93; 95% CI = 1.57-5.47; P for trend = < 0.001).CONCLUSIONS: This study showed the evidence that high fried food intake was significantly associated with high prevalence of prehypertension and hypertension combined among Filipino women married to Korean men.]]>
Blood Pressure ; Cross-Sectional Studies ; Diet ; Eating ; Emigrants and Immigrants ; Epidemiologic Studies ; Female ; Humans ; Hypertension ; Logistic Models ; Male ; Odds Ratio ; Prehypertension ; Prevalence

PURPOSE: The main purpose of this study was to compare the relationships between physical activity (measured using an accelerometer vs. self-reported) and cardiovascular disease risk factors. Differences in accelerometry physical activity between 10-minute bouts and total bouts were also compared.METHODS: Data originated from the Korea National Health and Nutrition Examination Survey. Logistic regression was used to predict cardiovascular disease risk from physical activity levels.RESULTS: Self-reported physical activity could not significantly predict the odds of having cardiovascular risk. However, the insufficiently active group classified according to the total-bout physical activity had significantly greater odds of having hypertension or prehypertension (odds ratio [OR], 1.35; 95% confidence interval [95% CI], 1.00–1.82), diabetes mellitus (OR, 1.77; 95% CI, 1.01–3.19), and dyslipidemia (OR, 1.65; 95% CI, 1.17–2.36) than the highly active group. Regarding the 10-minute bout physical activity, the inactive group had significantly greater odds of having only hypertension or prehypertension (OR, 1.67; 95% CI, 1.02–2.76) than the highly active group.CONCLUSION: Total-bout physical activity measured using an accelerometer could significantly predict the cardiovascular disease risk compared to 10-minute bout physical activity. However, self-reported physical activity could not significantly predict the cardiovascular disease risk.
Accelerometry ; Cardiovascular Diseases ; Diabetes Mellitus ; Dyslipidemias ; Hypertension ; Korea ; Logistic Models ; Motor Activity ; Nutrition Surveys ; Prehypertension ; Risk Assessment ; Risk Factors ; Self Report

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in the general population. Many cardiovascular diseases and concomitant conditions increase the risk of the development of AF, recurrent AF, and AF-associated complications. Knowledge of these factors and their management is hence important for the optimal management of patients with AF. Recent studies have suggested that lowering the blood pressure threshold can improve the patients' outcome. Moreover, adverse events associated with a longer duration of hypertension can be prevented through strict blood pressure control. Pre-hypertension, impaired fasting glucose, abdominal obesity, weight fluctuation, and exposure to air pollution are related to the development of AF. Finally, female sex is not a risk factor of stroke, and the age threshold for stroke prevention should be lowered in Asian populations. The management of diseases related to AF should be provided continuously, whereas lifestyle factors should be monitored in an integrated manner.
Air Pollution ; Arrhythmias, Cardiac ; Asian Continental Ancestry Group ; Atrial Fibrillation ; Blood Pressure ; Cardiovascular Diseases ; Fasting ; Female ; Glucose ; Humans ; Hypertension ; Life Style ; Obesity ; Obesity, Abdominal ; Prehypertension ; Risk Factors ; Stroke

BACKGROUND: Microalbuminuria (MA) is a predictor for diabetic nephropathy and mortality of cardiovascular disease. Diabetic nephropathy can be prevented by blood glucose and blood pressure control. Koreans have been found to have a significantly higher risk of type 2 diabetes than Caucasians, despite having normal weights. It is necessary to consider obesity status in the prevention of type 2 diabetes. This study aimed to determine the relationship between MA and hypertension according to obesity status in prediabetes.METHODS: This study was retrospectively conducted in 1,183 prediabetes, aged 30-70 years with fasting blood glucose levels of 100-125 mg/dL or hemoglobin A1c levels of 5.7–6.4% who health examinees at 16 health promotion centers from 2015 to 2016. Study subjects were classified according to obesity and hypertension. Obesity is defined as body mass index of ≥25 kg/m². Blood pressure was categorized as follows: normal blood pressure, <120/80 mmHg; prehypertension, 120–139/80–89 mmHg; and hypertension, ≥140/90 mmHg. We analyzed the relationship between MA and hypertension according to obesity using multivariable logistic regression analysis.RESULTS: While both prehypertensive and hypertensive subgroups were significantly associated with MA in the nonobese, the hypertensive subgroup was only associated with MA in the obese. In the combined effects of obesity and hypertension, prediabetes with normal weight and hypertension had the highest risk of MA (adjusted odds ratio, 6.39; 95% confidence interval, 2.90–14.10) compared to those with nonobese and normal blood pressure.CONCLUSIONS: Our findings suggest that nonobese prediabetes with hypertension would need to be more concerned about MA than do obese prediabetes with hypertension.
Albuminuria ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Diabetic Nephropathies ; Fasting ; Health Promotion ; Hypertension ; Logistic Models ; Mortality ; Obesity ; Odds Ratio ; Prediabetic State ; Prehypertension ; Retrospective Studies ; Weights and Measures

OBJECTIVES: The Korea International Cooperation Agency (KOICA) established 4 health centers to provide hypertension screening and a health support program in a deprived urban area of Lima, Peru. This case report provides a mid-term evaluation of the KOICA’s hypertension prevention and control programs. METHODS: A follow up study was performed on 663 residents who were diagnosed with prehypertension or hypertension (Stage 1 and 2) in the 4 KOICA health centers. Patients participated in programs designed to prevent and control hypertension through education sessions over the course of 6 months. Using simple descriptive statistics and computer simulations, we evaluated the effect of hypertension prevention and control programs on the participants. RESULTS: The KOICA health programs appeared to significantly contribute to lowering the blood pressure (BP) of the participants. The total number of participants with normal BP increased from none to 109. Overall, the female and younger patients responded better to the KOICA programs than the male and older participants. In addition, the average systolic BP, diastolic BP, and body mass index of all participants was significantly reduced. CONCLUSION: The KOICA programs were effective at lowering blood pressure, particularly amongst the prehypertension group than the Stage 1 and 2 hypertension groups. This suggests that providing an extensive screening service for adults with prehypertension will help control hypertension in the early stages.
Adult ; Blood Pressure ; Body Mass Index ; Computer Simulation ; Education ; Female ; Follow-Up Studies ; Humans ; Hypertension ; International Cooperation ; Korea ; Male ; Mass Screening ; Peru ; Prehypertension

OBJECTIVES: This study was conducted to determine the prevalence of hypertension in adolescents and to find the relationship between an increase of body mass index and waist circumference (WC) and blood pressure (BP). METHODS: Four hundred twenty-nine adolescents between the ages of 15 and 18 at high school in Seoul were enrolled and their anthropometric data and body composition were measured. BP was measured by oscillometric devices at least twice. Hypertension was defined according to the normative BP reference for Korean children and adolescents. RESULTS: The prevalence of prehypertension and hypertension was 14.0%, 9.2% in boys and 9.0%, 10.2% in girls. The prevalence of prehypertension and hypertension was 9.0%, 6.0% in the normal body mass index group, 14.6 %, 16.7% in the overweight group, 21.7%, 29.8% in the obese group. The prevalence of systolic hypertension was 3.6% in the normal group, 12.5% in the overweight group and 29.8% in the obese group. However, the prevalence of diastolic hypertension had significant differences between the groups, which were 3.3% in the normal group, 6.3% in the overweight group and 4.3% in the obese group. According to WC, the prevalence of hypertension was 6.2% in the below 75th percentile WC group, 22.2% in the75th to 90th percentile WC group and 25.6% in ≥90th percentile WC group. The risk of hypertension was 5.55 times higher in the obese group and 2.04 times higher in the overweight group, 3.93 times higher in ≥90th percentile of WC group. CONCLUSION: The risk of hypertension is markedly increased with obesity in high school students.
Adolescent ; Blood Pressure ; Body Composition ; Body Mass Index ; Child ; Female ; Humans ; Hypertension ; Obesity ; Obesity, Abdominal ; Overweight ; Prehypertension ; Prevalence ; Seoul ; Waist Circumference