Korean J Fam Pract. 2017; 7(4): 527-532  https://doi.org/10.21215/kjfp.2017.7.4.527
A Comparison of Predictability of Physician-Diagnosed Hypertension according to Major Cardiovascular Disease Risk Factors: A Nationwide Population-Based Retrospective Cohort Study
Jong-Eun Lee1, Jun-Seok Choi1, Jung-Eun Sang1, Youn Huh1, Hyo-Yun Nam1, Ga-Eun Nam1, Do-Hoon Kim1,*, Kyung-Do Han2
1Department of Family Medicine, Korea University Ansan Hospital, Ansan; 2Department of Medical Life Science, School of Medicine, The Catholic University of Korea, Seoul, Korea
Do-Hoon Kim
Tel: +82-31-412-5360, Fax: +82-31-412-7657
E-mail: kmcfm@hanmail.net
Received: April 1, 2016; Revised: September 19, 2016; Accepted: September 23, 2016; Published online: August 20, 2017.
© Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Cardiovascular disease risk factors are known to be predictors of type 2 diabetes and coronary events. We hypothesized that they may also predict hypertension. We aimed to evaluate the relationship between cardiovascular disease risk factors and development of hypertension, using retrospective cohort data.
Methods: This study used retrospective cohort data from the National Health Insurance Service in Korea. A total of 125,318 Korean adults over 30 years old, without pre-existing hypertension at baseline, were followed from 2009 to 2013. The prevalence of hypertension and cardiovascular disease risk factors, including central obesity, abnormal fasting glucose, and dyslipidemia, was assessed.
Results: During the median follow-up time of 3.9 years, 9,019 of the 125,318 subjects who were normotensive at baseline developed hypertension: 5,059 men and 3,960 women. The development of hypertension was examined by person-year (generating a population prevalence per 100 persons during a year), and by hazard ratio (HR). A significant increase was observed based on the number of metabolic syndrome components (P<0.001): elevated blood glucose (HR, 1.66), dyslipidemia (HR, 1.30), and large waist circumference (HR, 1.11); number of component 0: HR, 1; 1: HR, 1.28; 2: HR, 1.58; 3: HR, 2.05. After adjustment for age, sex, body mass index, smoking status, alcohol intake, and physical activity, elevated blood glucose has a more significant predictive value than any other metabolic syndrome component (HR, 1.66; 95% confidence interval, 1.56–1.77).
Conclusion: Metabolic syndrome amplifies hypertension development. Among the metabolic syndrome components, elevated blood glucose is the most powerful predictor for the development of hypertension.
Keywords: Central Obesity; Abnormal Glucose; Dyslipidemia; Hypertension; Risk Factors
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