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New US guideline adds 6.5 million to Korean hypertension patients
  • By Nam Doo-hyun
  • Published 2017.11.16 14:38
  • Updated 2017.11.16 14:38
  • comments 0

As the American Heart Association and the American College of Cardiology redefined high blood pressure as a reading of 130/80㎜Hg, down from 140/ 90㎜Hg, their Korean counterpart’s revised guideline to be announced early next year is drawing attention.

Applying the new U.S. guidelines to Korea, the number of Korean hypertension patients will rise from 10 million to 16.5 million, according to an analysis by the Korea Society of Hypertension. About 10 percent of the newly added 6.5 million patients are estimated to require a medical therapy, the society said.

A large-scale study supported the change in the U.S. guidelines, Systolic Blood Pressure Intervention Trial (SPRINT), led by the National Institutes of Health, and 900 other pieces of research. The studies concluded that a more active care of high blood pressure would effectively reduce mortality risks coming from cardiac insufficiency, myocardial infarction, and stroke.

The updated U.S. guidelines recommended an active blood pressure control through medications for those with a blood pressure reading over 130/80㎜Hg who also have a high risk of cardiovascular diseases. Others who are considered hypertensive can start medications when the reading is over 140/90㎜Hg.

The KSH said it is reviewing to put more importance in thoroughly managing hypertension in the future guidelines, as the new U.S. guidelines are emphasizing the management of early conditions to prevent complications.

However, it will further discuss whether to apply the same U.S. threshold of 130/80㎜Hg to Koreans, only after analyzing ethnic group differences and local data of the KSH’s internal committee for establishing guidelines. The KSH will also discuss with academic hypertension groups in Asia-Pacific countries and disclose its decision later.

“Koreans may have different drug reactions from those of Western people. After referencing papers and coordinating with Asian peer groups, we will announce our final decision,” said Cho Myeong-chan, president of the KSH and a professor at Chungbuk National University Hospital’s cardiovascular department, at a news conference in Gangnam-gu, southern Seoul. “While we have many things to consider, we don’t have a large-scale study on Koreans only. So, we have to put together various factors.”

The most significant update in the U.S. guidelines was to regard all the people with blood pressure over 130/80 ㎜Hg as hypertensive, regardless of diabetes or age. Europe has not released any official statement since the U.S. update of guidelines on Monday, but related academic groups are reportedly reviewing whether to set the target blood pressure level at 130/80 ㎜Hg or lower for the elderly.

“Although Europe has not made an official position, individual contacts told me that most of the European experts are likely to accept the new U.S. guidelines. But they have still doubted whether to set the target blood pressure at 130/80㎜Hg for the elderly,” Cho said.

Kang Seok-min, a director of the KSH and Severance Hospital’s physician at the cardiovascular department, said Korea should review whether it would be helpful to apply a strict guideline for senior hypertension patients.

“SPRINT study showed that a strict management of hypertensive elderly patients was effective to prevent them from developing complications. But in the reality of medical field, physicians should consider adverse drug reactions for patients in their 80s and 90s. A decision in Korea should be made based on Korean data,” Kang said.

Some physicians working at hospitals said doctors should make hypertension diagnosis based on the current guidelines, at least until the KSH updates them in early 2018.

hwz@docdocdoc.co.kr

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