Impact of global risk assessment on the evaluation of hypertensive patients treated by primary care physicians in Korea (A Nation-Wide, Multi-Center, Observational, Cross-Sectional, Epidemiologic Study to Evaluate the Proportion of Cardiovascular Risk Factors in Korean hypertensive patients: WONDER study)

Kwang Il Kim, Yil Seob Lee, Chang Gyu Park

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Global cardiovascular risk evaluation and stratification is essential to identify high-risk hypertensive patients. However, it is uncertain how often the strategy is executed in real clinical practice. We sought to evaluate whether global risk evaluation might change the risk stratification in Korean hypertensive patients treated by primary care physicians. A total of 3109 hypertensive patients were analyzed. The mean age was 62.3±11.3 years, and 1502 (48.3%) of the participants were male. The global risk evaluation revealed that 1862 patients (59.9%) were classified as having high- or the very high-risk. High-risk patients were older and obese, and had a male predominance, a longer duration of hypertension and a low HDL-cholesterol. The systolic and diastolic blood pressures (BP) were significantly higher in the high-risk group (P<0.0001). However, combination antihypertensive therapy was more common in the low-risk group (P=0.0265). A total of 2155 patients (69.3%) were reclassified into the higher or the lower-risk group by performing additional tests. In a multivariate logistic regression analysis, age, body mass index, BP, metabolic syndrome, left ventricular hypertrophy and chronic kidney disease were independent factors associated with risk reclassification with global risk evaluation. In conclusion, although the majority of hypertensive patients treated by the primary care physicians were in the high- or very high-risk group, their risk levels were not appropriately stratified. However, simple additional tests enhanced the risk evaluation of hypertensive patients. Accordingly, comprehensive cardiovascular risk stratification should be undertaken in all hypertensive patients.

Original languageEnglish
Pages (from-to)665-671
Number of pages7
JournalHypertension Research
Volume37
Issue number7
DOIs
Publication statusPublished - 2014 Jan 1

Fingerprint

Primary Care Physicians
Korea
Epidemiologic Studies
Cross-Sectional Studies
Blood Pressure
Left Ventricular Hypertrophy
Chronic Renal Insufficiency
HDL Cholesterol
Antihypertensive Agents

Keywords

  • control
  • global risk evaluation
  • risk stratification

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

@article{f1540101f0cb4d7bb8d00e9cf51094b1,
title = "Impact of global risk assessment on the evaluation of hypertensive patients treated by primary care physicians in Korea (A Nation-Wide, Multi-Center, Observational, Cross-Sectional, Epidemiologic Study to Evaluate the Proportion of Cardiovascular Risk Factors in Korean hypertensive patients: WONDER study)",
abstract = "Global cardiovascular risk evaluation and stratification is essential to identify high-risk hypertensive patients. However, it is uncertain how often the strategy is executed in real clinical practice. We sought to evaluate whether global risk evaluation might change the risk stratification in Korean hypertensive patients treated by primary care physicians. A total of 3109 hypertensive patients were analyzed. The mean age was 62.3±11.3 years, and 1502 (48.3{\%}) of the participants were male. The global risk evaluation revealed that 1862 patients (59.9{\%}) were classified as having high- or the very high-risk. High-risk patients were older and obese, and had a male predominance, a longer duration of hypertension and a low HDL-cholesterol. The systolic and diastolic blood pressures (BP) were significantly higher in the high-risk group (P<0.0001). However, combination antihypertensive therapy was more common in the low-risk group (P=0.0265). A total of 2155 patients (69.3{\%}) were reclassified into the higher or the lower-risk group by performing additional tests. In a multivariate logistic regression analysis, age, body mass index, BP, metabolic syndrome, left ventricular hypertrophy and chronic kidney disease were independent factors associated with risk reclassification with global risk evaluation. In conclusion, although the majority of hypertensive patients treated by the primary care physicians were in the high- or very high-risk group, their risk levels were not appropriately stratified. However, simple additional tests enhanced the risk evaluation of hypertensive patients. Accordingly, comprehensive cardiovascular risk stratification should be undertaken in all hypertensive patients.",
keywords = "control, global risk evaluation, risk stratification",
author = "Kim, {Kwang Il} and Lee, {Yil Seob} and Park, {Chang Gyu}",
year = "2014",
month = "1",
day = "1",
doi = "10.1038/hr.2014.55",
language = "English",
volume = "37",
pages = "665--671",
journal = "Hypertension Research",
issn = "0916-9636",
publisher = "Nature Publishing Group",
number = "7",

}

TY - JOUR

T1 - Impact of global risk assessment on the evaluation of hypertensive patients treated by primary care physicians in Korea (A Nation-Wide, Multi-Center, Observational, Cross-Sectional, Epidemiologic Study to Evaluate the Proportion of Cardiovascular Risk Factors in Korean hypertensive patients

T2 - WONDER study)

AU - Kim, Kwang Il

AU - Lee, Yil Seob

AU - Park, Chang Gyu

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Global cardiovascular risk evaluation and stratification is essential to identify high-risk hypertensive patients. However, it is uncertain how often the strategy is executed in real clinical practice. We sought to evaluate whether global risk evaluation might change the risk stratification in Korean hypertensive patients treated by primary care physicians. A total of 3109 hypertensive patients were analyzed. The mean age was 62.3±11.3 years, and 1502 (48.3%) of the participants were male. The global risk evaluation revealed that 1862 patients (59.9%) were classified as having high- or the very high-risk. High-risk patients were older and obese, and had a male predominance, a longer duration of hypertension and a low HDL-cholesterol. The systolic and diastolic blood pressures (BP) were significantly higher in the high-risk group (P<0.0001). However, combination antihypertensive therapy was more common in the low-risk group (P=0.0265). A total of 2155 patients (69.3%) were reclassified into the higher or the lower-risk group by performing additional tests. In a multivariate logistic regression analysis, age, body mass index, BP, metabolic syndrome, left ventricular hypertrophy and chronic kidney disease were independent factors associated with risk reclassification with global risk evaluation. In conclusion, although the majority of hypertensive patients treated by the primary care physicians were in the high- or very high-risk group, their risk levels were not appropriately stratified. However, simple additional tests enhanced the risk evaluation of hypertensive patients. Accordingly, comprehensive cardiovascular risk stratification should be undertaken in all hypertensive patients.

AB - Global cardiovascular risk evaluation and stratification is essential to identify high-risk hypertensive patients. However, it is uncertain how often the strategy is executed in real clinical practice. We sought to evaluate whether global risk evaluation might change the risk stratification in Korean hypertensive patients treated by primary care physicians. A total of 3109 hypertensive patients were analyzed. The mean age was 62.3±11.3 years, and 1502 (48.3%) of the participants were male. The global risk evaluation revealed that 1862 patients (59.9%) were classified as having high- or the very high-risk. High-risk patients were older and obese, and had a male predominance, a longer duration of hypertension and a low HDL-cholesterol. The systolic and diastolic blood pressures (BP) were significantly higher in the high-risk group (P<0.0001). However, combination antihypertensive therapy was more common in the low-risk group (P=0.0265). A total of 2155 patients (69.3%) were reclassified into the higher or the lower-risk group by performing additional tests. In a multivariate logistic regression analysis, age, body mass index, BP, metabolic syndrome, left ventricular hypertrophy and chronic kidney disease were independent factors associated with risk reclassification with global risk evaluation. In conclusion, although the majority of hypertensive patients treated by the primary care physicians were in the high- or very high-risk group, their risk levels were not appropriately stratified. However, simple additional tests enhanced the risk evaluation of hypertensive patients. Accordingly, comprehensive cardiovascular risk stratification should be undertaken in all hypertensive patients.

KW - control

KW - global risk evaluation

KW - risk stratification

UR - http://www.scopus.com/inward/record.url?scp=84904884884&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84904884884&partnerID=8YFLogxK

U2 - 10.1038/hr.2014.55

DO - 10.1038/hr.2014.55

M3 - Article

C2 - 24739540

AN - SCOPUS:84904884884

VL - 37

SP - 665

EP - 671

JO - Hypertension Research

JF - Hypertension Research

SN - 0916-9636

IS - 7

ER -