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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
Authors
Shin J.-H.Jung M.-H.Kwon C.H.Lee C.J.Kim D.-H.Kim H.-L.Kim W.Kang S.-H.Lee J.-H.Kim H.M.Cho I.-J.Cho I.Lee J.H.Kang D.R.Lee H.-Y.Chung W.-J.Ihm S.-H.Kim K.I.Cho E.J.Sohn I.-S.Kim H.-C.Park S.Shin J.Kim J.H.Ryu S.K.Kang S.-M.Pyun W.B.Cho M.-C.Sung K.-C.
Ewha Authors
편욱범조인정
SCOPUS Author ID
편욱범scopus; 조인정scopusscopus
Issue Date
2021
Journal Title
Journal of the American Heart Association
ISSN
2047-9980JCR Link
Citation
Journal of the American Heart Association vol. 10, no. 7
Keywords
Blood pressureCardiovascular diseasesHealth status disparitiesHypertensionIncomeMortality
Publisher
American Heart Association Inc.
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
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. © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
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DOI
10.1161/JAHA.120.018446
Appears in Collections:
의과대학 > 의학과 > Journal papers
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