PHWR Public Health Weekly Report

Vol.14 No.20, May 13, 2021 Article TypeEpidemiology and SurveillanceNoncommunicable Disease Statistics

• Epidemiology and Surveillance 2021-05-13

  0 376 76

  The clinical importance of office BP 130/80 mmHg in resistant hypertension

  Lee Chan Joo, Park Sungha, Lee Joung-Won, Lee Seung Hee, Kim Won-Ho

  Public Health Weekly Report 2021; 14(20): 1314-1325

  

  

  Abstract

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  Resistant hypertension has a high risk of end-stage renal disease, cardiovascular disease, and death, so it is important to detect resistant hypertension properly and actively control blood pressure (BP). BP can be diagnosed based on office blood pressure, but, when the readings are inaccurate due to certain environments, many patients are classified as white-coat uncontrolled hypertension or masked uncontrolled hypertension with ambulatory BP monitoring. Therefore, it is recommended to use ‘out-of-office’ BP monitoring, such as an active blood pressure test, to determine an appropriate treatment policy for resistant hypertension. Still, this convention is not fully utilized in clinical practice. The objective of this study was to compare the diagnostic accuracy of office BP thresholds of 140/90 and 130/80 mmHg to correctly identify uncontrolled out-of-office BP in resistant hypertension. As a multicenter study conducted in Korea, the results of 468 patients enrolled in the resistant hypertension cohort were analyzed. Office BP, home BP, and ambulatory BP were measured at baseline. Resistant hypertension was defined as office BP ≥ 130/80 mmHg with three different classes of antihypertensive medications, including thiazide-type/like diuretics or treated hypertension with four or more different classes of antihypertensive medications. Uncontrolled out-of-office BP was defined as daytime BP ≥ 135/85 mmHg and/or home BP ≥ 135/85 mmHg. For the diagnosis of uncontrolled out-of-office BP, the accuracy of an office blood pressure of 140/90 mmHg was 60.9%, but the accuracy of an office blood pressure of 130/80 mmHg was 74.1%. When the office BP threshold was changed from 140/90 mmHg to 130/80 mmHg, the net reclassification index for the diagnosis of BP outside the uncontrolled office was 0.543. When the office BP threshold was lowered, the proportion of patients with masked uncontrolled hypertension that were easily neglected to treat decreased. In conclusion, an office BP of 130/80 mmHg can be more accurately classified as uncontrolled out-of-office BP than as office BP 140/90 mmHg and lowering the office BP threshold can be helpful for controlling BP in resistant hypertension.

• Epidemiology and Surveillance 2021-05-13

  0 193 121

  Pulmonary hypertension (PH) platform for deep phenotyping in Korean subjects (PHOENIKS) cohort and discovery Korean specific biomarkers for PH

  Kim Minsu, Moon Eunkyung, You Mi Ju, Jang Albert Youngwoo, Ahn Kyung Jin, Hyun Gyeong-Lim, Oh Seyeon, Byun Kyunghee, Chung Wook-Jin, Kim Seungwoo, Hong Jung Yeon, Lee Seung Hee, Kim Won-Ho

  Public Health Weekly Report 2021; 14(20): 1326-1337

  

  

  Abstract

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  Pulmonary arterial hypertension (PAH) is a rare and fatal disease resulting from several causes including heterogeneous genetic defects. Despite the development of various treatments, it is still impossible to cure, and the average survival rate is 7.4 years. Although the lethality for PAH is very high, in Korea, only the prevalence rate, survival rate within 3 years and the relationship between the prevalence of BMPR2 gene mutants and Korean Idiopathic PAH (IPAH) have been identified through PAH registration project. With increasing interest in personalized medicine, the “biomarker” market for PAH is growing rapidly. In this situation, in order to enhance international competitiveness, we should induce the diversification of therapeutic target candidates by discovering new biomarkers, and produce basic data necessary for new drug development. For these reasons, not only clinical data on deep phenotyping but also biological specimens in patients with PAH are required.
  In the field of translational research in PAH, where there is no research using biological specimens to date, the long-term cohort research platform for Korean PAH (PHOENIKS) ordered by The Korea National Institute of Health, Korea Disease Control and Prevention Agency (KDCA) was designed to collect human samples for deep phenotyping in patients with PAH and to build a database of patients with PAH in Korea. In this project, we obtained basic data and human samples of 102 patients with primary and secondary PAH for about 3 years from 2018 to 2020. Throughout this research, we collected the clinical data of not only patients with inherited pulmonary arterial hypertension but also of patients with connective tissue disease, congenital heart disease, and portopulmonary hypertension, which belong to the accompanying diseases and secured an efficient follow-up observation system through a multi-center research network. From these processes, we discovered the therapeutic targets by investigating causes and pathophysiology of PAH and produced basic data necessary for the development of effective new drugs.
  In the second project (from 2021 to 2023) of a follow-up study, we are planning to research an additional deep phenotyping study of group 2 pulmonary hypertension patients and have already begun analyzing genomes and proteomics to discover Korean-specific diagnostic biomarkers and new therapeutic targets.

• Epidemiology and Surveillance 2021-05-13

  0 419 80

  Key findings of the 2020 Korea Community Health Survey

  Won Ji Su, Ko Yunsil, Park Ji-Hyun, So Seung-Hwi, Choi Sun Hye, Lee Seon Kui

  Public Health Weekly Report 2021; 14(20): 1338-1351

  

  

  Abstract

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  The Korea Community Health Survey (KCHS) is a survey conducted jointly by the Korea Disease Control and Prevention Agency (KDCA) and 255 public health centers to determine the health status of residents based on the law. Since 2008, this survey has been targeting about 900 people (aged 19 and over) per public health center. Notably, in 2020, due to the COVID-19 pandemic, the number of survey questions was reduced and thorough quarantine regulations were followed, and a total of 229,000 people were interviewed through household visits.
  According to the 2020 KCHS, the rate of smoking and drinking increased, personal hygiene improved, and physical activity and mental health slightly worsened. Personal hygiene such as hand washing, guidance for COVID-19 such as wearing masks, and increased reliance on delivery for food consumption, decreased physical activity and alcohol consumption appear to have been affected by COVID-19. Also, on most of the indicators, the gap between regions was not significant and the gaps were still high.
  The survey results are available at the KCHS website (https://chs.kdca.go.kr), and can be used to improve the health of local residents.

• Epidemiology and Surveillance 2021-05-13

  0 289 460

  Physical and psychological changes during menopausal transition: a prospective cohort study of middle-aged Korean women

  NamGoung SunJu, Ryu Seungho, Chang Yoosoo, Cho Juhee, Lim Nam-Kyoo, Park Hyun-Young

  Public Health Weekly Report 2021; 14(20): 1352-1362

  Abstract

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  The vast majority of the female population experience extensive physical/psychological shifts during their menopausal transition(i.e., perimenopause). Although these changes can gradually develop by complex menopausal stages, menopausal research considering each menopausal stage is relatively scarce in Korea. Previous studies were limited by cross-sectional design, resulting in ambiguous temporal relationships between menopausal stages and risk factors. Therefore, a prospective cohort study of middle-aged Korean women was planned to better understand the time-course of physical/psychological health indicators including chronic diseases and their risk factors across menopausal stages. In this study, a total of 5,246 middle aged (42-52 years old) were recruited from 2014 to 2018. The average follow-up period was short (3.0±1.68 years) and only a small proportion (about 15%) of the female participants experienced menopause, which required further long-term follow-up to allow for all participants to reach menopause. At the time of writing (2021), most participants experienced early menopausal transition. At this stage in the study, the results of the population were analyzed. Menopause-related symptoms, previously considered to occur at menopause were more frequently observed in women at early menopausal transition than those at the pre-menopausal stage. This trend was observed in overall menopause-specific quality of life (MENQOL) and in four specific symptom domains (vasomotor symptoms, psychosocial symptoms, physical symptoms, and genitourinary symptoms). Vasomotor symptoms, a cardinal climacteric symptom, were more frequently observed in women with obesity, abdominal obesity, metabolically unhealthy status, abnormal lipid profiles, and hypertension than in those without. Also, an analysis of the impact of health behaviors on vasomotor symptoms indicated that no drinking, no smoking, and a high level of physical activity appear to be beneficial for reducing vasomotor symptoms. This ongoing study with further long-term follow-up is expected to provide a foundation to health policies regarding the prevention and management of these symptoms, contributing to improving female middle-age quality of life and long-term outcomes.

• Epidemiology and Surveillance 2021-05-13

  0 270 220

  Results of the 2020 Heat-Related Illness Surveillance

  Lee Sukyung, Kim Sunmi, Kim Hyoeun, Kwon Seunghyun, Yoo Hyosoon

  Public Health Weekly Report 2021; 14(20): 1363-1372

  

  

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  In 2011, the Korea Disease Control and Prevention Agency (KDCA) launched a heat-related illness (HRI) surveillance system. Annually, a nationwide network of approximately 500 hospital emergency rooms (ERs) participates in the system during the summer, the hottest part of the year in Korea. From May 20 to September 13, 2020, the KCDA operated the HRI surveillance system to monitor heat stroke, heat exhaustion, heat cramps, heat syncope, and heat edema. According to hospital reports, 1,078 people developed HRIs and 9 deaths were attributed to HRI in 2020. Findings indicated that the percentage of HRI occurrences was high among males (77.3%); and high among people in their 50s (22.6%). In terms of location, HRI occurrence was highest at outdoor workplace (35.1%) followed by outdoor farmland (19.7%) and outdoor roadside locations (12.2%). Findings indicated that the main cause of HRI was heat exhaustion (53.4%) followed by heat stroke (20.6%).

• Noncommunicable Disease Statistics 2021-05-13

  0 178 106

  Trends in prevalence of hypertension among people aged 30 years and over, 2007-2019

  Public Health Weekly Report 2021; 14(20): 1373-1376

  

  

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