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KMID : 0360919700130020133
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Journal of the Korean Medical Association
1970 Volume.13 No. 2 p.133 ~ p.154
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A CLINICAL STUDY ON ESSENTIAL HYPERTENSION IN KOREANS
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李聖浩/Lee, Sung Ho
李凡弘/李聖煥/李迎雨/李泰實/趙燦成/Lee, Bum Hong/Lee, Sung Whan/Lee, Young Woo/Lee, Tae Sil/Cho, Chan Sang
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Abstract
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Hypertension is now one of the popular disease among Koreans as it is in the other part of the world. For an adequate understanding of the hypertension in Korea, however, there are a little about the clinicaland epidemiological surveys.
The purpose of this paper is to clarify the knowledges concerning the hospital occurence of hypertension and hypertensive diseases.
A clinical study was performed on 2,224 cases of essential hypertension observed at Dept. of Internal Medicine of Seoul National University Hospital during a period of last 8 years from 1960 to 1967. The following were the results;
1. The mean age of all cases was 50.8 years and it was 50.6 years in male and was 50.9 years in female patients.
The highest occurence was observed in sixth decade and accounted for 33.9% of all cases and the least occurence was in second decade of life which accountedfor 0.8% of all cases. No difference was found in age distribution between both sexes.
2. The incidence of hypertensive patients among all medical out-patients was 1.6% and no difference was found in both sexes.
The male to female ratio, however, was 1.2 : 1.
The annual incidence was not so different but the number of hypertensive patients seemed to increannually.
3. The mean value of blood pressure levels was 181. 8/110. 5mmHg and tended to increase with age, at least over the decades from second to sixth and there was a tendency to decrease after the seventh decade, especially in diastolic blood pressure. No particular difference in blood pressure levels was found in both sexes.
The most outstanding symptom was headache which was found in 52.8% of all cases. Dizziness dyspnea and palpitation were the next orders it frequency.
There was a general trend of the subjective symptoms which were more pronounced in younger ant female than older and male patients except dyspnea.
There was no correlation between age or blood pressure levels and subjective symptoms except dyspnea.
5. Hypertensive retinopathy was found in 84.4% of all cases. Hypertensive retinopathy of K-W grade II was found in 37.9% of all cases and was the most frequent finding among the Keith-Waggrades.
The abnormal retinal finding was found to be rather proportional to the age and blood pressure levels. Malignant hypertension of K-W grade Ⅳ was found in 4.9% of all cases and the largest numbers were between the fifth and sixth decade of life whereas the highest incidence was observed in the eighth decade.
Hypertensive retinopathy of K-W Ⅲ and Ⅳ was more frequent in male than in female patients.
6. Albuminuria was detected in 53.6% of all cases and it was more frequent in female than in male patients.
Severe degree of albuminuria, however, was more frequent in male than in female patients.
The appearance of albuminuria seemed to have a close correlation with increasing age, hypertensive retinal changes or blood pressure levels, partiwith diastolic blood pressure.
7. The mean value of serum cholesterol levels was 189.7mg% which is 25 to 45mg% above the average of normal Koreans. No correlation was found between the level of serum cholesterol and age or degree of blood pressures.
There was a close correlation between sclerotic changes of the retina and serum cholesterol level, and hence, causative relation can be suggested between arteriosclerosis and cholesterol.
8. Hypertensive retinopathy and level of blood urea nitrogen were closely correlated.
9. Electrocardiographic abnormalities were associated in 70.1% of all cases.
The most frequent association among electrocardiographic abnormalities was left ventricular hypertrophy which accounted for 46.8% of all cases.
There was no correlation between age and electrocardiographic findings. There was the reverse correlation between the appearance of normal elect rocardiogram and age or degree. of blood pressures. The finding of left ventricular hypertrophy and degree of blood pressures were closely correlated, particularly with diastolic blood pressure.
10. Cardiomegaly on roentgenogram was found in 47.6% of all cases and close correlation was found between the incidence of cardiomegaly and degree of blood pressures.
11. The incidences of left ventricular hypertrophy on electrocardiogram and cardiomegaly on roent genogram were found in almost equal part and in both, those were more frequent in male than in female patients.
12. Cerebrovascular accident, congestive heart failure and renal failure were consisted of three majcomplications. It was recorded in 9.0%, 5.0% and 2.1% of all cases respectively. The complicatwere more common in men than in women. Cerebrovascular accident, congestive heart failure and renal failure were closely correlated with hypretinopathy.
13. Overall mortality during the last three years was 7.1%. Causes of death were; cerebrovascular accident 6.0%, renal failure 0.7%, congestive heart failure 0.4% and myocardial infarction was 0.09% of all cases.
Mortality rate was high in the fifth and sixth decades of life, with the peak incidence in the fifth decade and the highest numbers in the sixth decade.
Mortality rate was more common in men than in women as it was in the complication. Mortality rate was high in the cases with advanced retinal change and was closely correlated with degree of blood pressures, particularly with diastolic blood pressure.
14. From the prognostic view point, it can be suggested that the most reliable signs in hypertension were the degree of hypertensive retinopathy andthe level of diastolic blood pressure.
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KEYWORD
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