Magnitude of hypertension: based on the KNHNAES

The average blood pressure of Korean adults has decreased between 1998 and 2008, but there has been little change in the last 10 years. Population mean SBP/DBP level was 119/76 mmHg for Korean adults aged 20 years or older (Supplement, page 6). Over the last 20 years, the age-standardized mean blood pressure levels have decreased yet without significant change in recent years. The age-standardized prevalence of hypertension among adults aged 20 years or older also modestly decreased from 26.0% (men 29.6%, women 22.3%) in 1998 to 22.5% (men 25.9%, women 18.8%) in 2019 (Supplement, page 8). Over the same period, the age-standardized prevalence of hypertension among adults aged 30 years or older decreased from 30.8% (men 33.4%, women 27.4%) to 27.2% (men 31.1%, women 22.8%) (Supplement, page 9). However, with the rapid aging of the population, the absolute number of people with hypertension has steadily increased; as of 2019, the number has exceeded 12 million. In particular, the number of elderly women with hypertension has increased rapidly. In 2019, estimated people with hypertension was 4.34 million men and 2.78 million women under the age of 65, but 1.96 million men and 2.99 million women aged 65 years or older (Supplement, page 7).

Hypertension management status: based on the KNHANES

In general, the hypertension management (awareness, treatment, and control rates) has improved significantly over the past two decades. In 2019, among adults aged 20 or older with hypertension, the awareness rate was 70%, the treatment rate was 63%, and the control rate was 48%. However, the degree of management varied greatly by age and sex. All management indices were better in older adults than in young adults, and higher in women than in men. However, gender-difference varies depending on age. Women under the age of 50 have higher awareness, treatment, and control rates compared to men of same age. After the age of 60, the awareness and treatment rates become similar in men and women, and the control rate is even lower in women than in men (Supplement, pages 5, 11–14).

Healthcare utilization for hypertension: based on the NHI big data

The number of people diagnosed with hypertension has increased 3.3 times from 3 million in 2002 to 10.1 million in 2019. People receiving antihypertensive medications also increased 3.8 times from 2.5 million in 2002 to 9.5 million in 2019. More importantly, the number of people adherent to antihypertensive medication has increased more than tenfold from 0.6 million in 2002 to 6.9 million in 2019 (Supplement, page 15). The use of combination therapy has rapidly increased, with 40.6% using one class, 43.4% using two classes, and 16.0% using three or more classes of antihypertensive drug in 2018 (Supplement, page 16). In 2019, the most commonly prescribed antihypertensive drug class was ARB (72.5%), followed by CCB (60.9%), diuretics (24.7%), beta-blockers (15.7%), potassium-sparing diuretics (1.8%) and ACEi (1.8%) (Supplement, page 17). Overall, the types of antihypertensive medication were not significantly different between men and women. However, when limited to age of 20–39, monotherapy was more common in women than in men (60.0% vs. 38.1%), and ACEi/ARB prescriptions (59.5% vs. 83.7%) and CCB prescriptions were less common (48.6% vs. 61.8%) in women than in men (Supplement, page 18).

Hypertensive disorders of pregnancy

The number of childbirths has been declining for the past 10 years, but number of pregnancies complicated with hypertension is rather increasing. In 2019, out of 298.8 thousand childbirths, 26.9 thousand women had hypertensive disorders during pregnancy. It is estimated that the prevalence of hypertensive disorder complicating pregnancies is 5.4% for chronic hypertension, 3.1% for pregnancy-induced hypertension, and 1.8% for preeclampsia/eclampsia (Supplement, page 20–21).

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