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Disparities in Mortality and Cardiovascular Events by Income and Blood Pressure Levels Among Patients With Hypertension in South Korea
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 sta...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174369/ https://www.ncbi.nlm.nih.gov/pubmed/33719521 http://dx.doi.org/10.1161/JAHA.120.018446 |
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author | Shin, Jeong‐Hun Jung, Mi‐Hyang Kwon, Chang Hee Lee, Chan Joo Kim, Dae‐Hee Kim, Hack‐Lyoung Kim, Woohyeun Kang, Si‐Hyuck Lee, Ju‐Hee Kim, Hyue Mee Cho, In‐Jeong Cho, Iksung Lee, Jun Hyeok Kang, Dae Ryong Lee, Hae‐Young Chung, Wook‐Jin Ihm, Sang‐Hyun Kim, Kwang Il Cho, Eun Joo Sohn, Il‐Suk Kim, Hyeon‐Chang Park, Sungha Shin, Jinho Kim, Ju Han Ryu, Sung Kee Kang, Seok‐Min Pyun, Wook Bum Cho, Myeong‐Chan Sung, Ki‐Chul |
author_facet | Shin, Jeong‐Hun Jung, Mi‐Hyang Kwon, Chang Hee Lee, Chan Joo Kim, Dae‐Hee Kim, Hack‐Lyoung Kim, Woohyeun Kang, Si‐Hyuck Lee, Ju‐Hee Kim, Hyue Mee Cho, In‐Jeong Cho, Iksung Lee, Jun Hyeok Kang, Dae Ryong Lee, Hae‐Young Chung, Wook‐Jin Ihm, Sang‐Hyun Kim, Kwang Il Cho, Eun Joo Sohn, Il‐Suk Kim, Hyeon‐Chang Park, Sungha Shin, Jinho Kim, Ju Han Ryu, Sung Kee Kang, Seok‐Min Pyun, Wook Bum Cho, Myeong‐Chan Sung, Ki‐Chul |
author_sort | Shin, Jeong‐Hun |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8174369 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-81743692021-06-11 Disparities in Mortality and Cardiovascular Events by Income and Blood Pressure Levels Among Patients With Hypertension in South Korea Shin, Jeong‐Hun Jung, Mi‐Hyang Kwon, Chang Hee Lee, Chan Joo Kim, Dae‐Hee Kim, Hack‐Lyoung Kim, Woohyeun Kang, Si‐Hyuck Lee, Ju‐Hee Kim, Hyue Mee Cho, In‐Jeong Cho, Iksung Lee, Jun Hyeok Kang, Dae Ryong Lee, Hae‐Young Chung, Wook‐Jin Ihm, Sang‐Hyun Kim, Kwang Il Cho, Eun Joo Sohn, Il‐Suk Kim, Hyeon‐Chang Park, Sungha Shin, Jinho Kim, Ju Han Ryu, Sung Kee Kang, Seok‐Min Pyun, Wook Bum Cho, Myeong‐Chan Sung, Ki‐Chul J Am Heart Assoc Original Research 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. John Wiley and Sons Inc. 2021-03-15 /pmc/articles/PMC8174369/ /pubmed/33719521 http://dx.doi.org/10.1161/JAHA.120.018446 Text en © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Shin, Jeong‐Hun Jung, Mi‐Hyang Kwon, Chang Hee Lee, Chan Joo Kim, Dae‐Hee Kim, Hack‐Lyoung Kim, Woohyeun Kang, Si‐Hyuck Lee, Ju‐Hee Kim, Hyue Mee Cho, In‐Jeong Cho, Iksung Lee, Jun Hyeok Kang, Dae Ryong Lee, Hae‐Young Chung, Wook‐Jin Ihm, Sang‐Hyun Kim, Kwang Il Cho, Eun Joo Sohn, Il‐Suk Kim, Hyeon‐Chang Park, Sungha Shin, Jinho Kim, Ju Han Ryu, Sung Kee Kang, Seok‐Min Pyun, Wook Bum Cho, Myeong‐Chan Sung, Ki‐Chul Disparities in Mortality and Cardiovascular Events by Income and Blood Pressure Levels Among Patients With Hypertension in South Korea |
title | Disparities in Mortality and Cardiovascular Events by Income and Blood Pressure Levels Among Patients With Hypertension in South Korea |
title_full | Disparities in Mortality and Cardiovascular Events by Income and Blood Pressure Levels Among Patients With Hypertension in South Korea |
title_fullStr | Disparities in Mortality and Cardiovascular Events by Income and Blood Pressure Levels Among Patients With Hypertension in South Korea |
title_full_unstemmed | Disparities in Mortality and Cardiovascular Events by Income and Blood Pressure Levels Among Patients With Hypertension in South Korea |
title_short | Disparities in Mortality and Cardiovascular Events by Income and Blood Pressure Levels Among Patients With Hypertension in South Korea |
title_sort | disparities in mortality and cardiovascular events by income and blood pressure levels among patients with hypertension in south korea |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174369/ https://www.ncbi.nlm.nih.gov/pubmed/33719521 http://dx.doi.org/10.1161/JAHA.120.018446 |
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