Disparities in mortality and cardiovascular events by income and blood pressure levels among patients with hypertension in South Korea

Jeong Hun Shin, Mi Hyang Jung, Chang Hee Kwon, Chan Joo Lee, Dae Hee Kim, Hack Lyoung Kim, Woohyeun Kim, Si Hyuck Kang, Ju Hee Lee, Hyue Mee Kim, In Jeong Cho, Iksung Cho, Jun Hyeok Lee, Dae Ryong Kang, Hae Young Lee, Wook Jin Chung, Sang Hyun Ihm, Kwang Il Kim, Eun Joo Cho, Il Suk SohnHyeon Chang Kim, Sungha Park, Jinho Shin, Ju Han Kim, Sung Kee Ryu, Seok Min Kang, Wook Bum Pyun, Myeong Chan Cho, Ki Chul Sung

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

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.

Original languageEnglish
Article numbere018446
JournalJournal of the American Heart Association
Volume10
Issue number7
DOIs
StatePublished - 2021

Keywords

  • Blood pressure
  • Cardiovascular diseases
  • Health status disparities
  • Hypertension
  • Income
  • Mortality

Fingerprint

Dive into the research topics of 'Disparities in mortality and cardiovascular events by income and blood pressure levels among patients with hypertension in South Korea'. Together they form a unique fingerprint.

Cite this