VALIDATION OF KOREAN SOCIETY OF HYPERTENSION RISK SCORING IN COMPARISON WITH FRAMINGHAN RISK SCORE IN CALCULATING THE PREVALENCE OF SPRINT ELIGIBLE SUBJECTS USING KOREAN NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY (KNHANES)

Abstract

Objective: Systolic Blood Pressure Intervention Trial (SPRINT) provided the evidence for additional blood pressure (BP) reduction therapy using antihypertensive medication (AHM) for whose BP is 130 mmHg or higher. But due to the extensive exclusion criteria, the clinical applicability has been challenged. Moreover, the applicability to Asian ethnicity remains to be clarified. This study is to identify the prevalence of SPRINT eligible population using Korean National Health and Nutrition Examination Survey (KNHANES).

Design and Method: For 34073 subjects aged 30 or more during the period of 1998 ∼2010 was analyzed. Because the number of AHM was not available, the BP category was operationally defined. Category 1 is BP between 130 and 180 mmHg without AHM treatment. Category 2 was BP between 130 and 160 mmHg with AHM treatment and category 3 was BP between 160 and 180 mmHg with AHM treatment.

Results: Age was 51.6 ± 14.2 and female was 57.0%. BPs were 121.5 ± 18.9/77.0 ± 11.3 mmHg. Fasting blood glucose was 99.2 ± 24.9 mg/dL. The number of CV risk factor and clinical CV disease were 2.1 ± 0.9 and 8.7%. For 6924 hypertension patients, 1901 (27.4%) was aged under 50 and 1800 subjects (25.9%) were with diabetes or stroke history. Among 3223 subjects, 1059 (21.7%) were Framingham 10 year CV risk > 15 % or higher. According to the KoSH guideline, 1947 (28.1%) was KoSH 10 year CV risk > 15%. BP category 1, 2, and 3 was 155 (8.0%), 1463 (45.3%), and 329 (10.2%), respectively.

Conclusions: The applicability of the SPRINT study can be differently assessed mainly by the locally adopted scoring system to define high risk subgroup. With limitations of the pending information of pill count, for the representative population for Korea, overall prevalence of the subjects potentially benefitted by tight BP control subjects seems to be higher than expected.