Sex differences in hypertension prevalence and control: Analysis of the 2010-2014 Korea National Health and Nutrition Examination Survey

Abstract

Although not fully understood, sex may affect both the prevalence and control rate of hypertension. The present study was designed to investigate factors associated with hypertension prevalence and control among Korean adults. We analyzed 27,887 individuals (12,089 males and 15,798 females) aged 30 years or older who participated in the fifth (2010-2012) and sixth (2013-2014) Korea National Health and Nutrition Examination Survey. Multiple logistic regression models were applied to delineate factors associated with the prevalence and control of hypertension separately for men and women. Overall, the prevalence of hypertension was higher in men (34.6%) than in women (30.8%). However, after the age of 60 years, hypertension was more prevalent in females than in males. Regardless of sex, the older the participants were, the more likely they were to have hypertension. Factors positively associated with hypertension prevalence were old age, low education, and high BMI in women (p<0.001) and increasing age, low income, alcohol intake, and high BMI in men (p<0.001). The overall control rate of hypertension was higher in women (51.3%) than in men (44.8%). However, after the age of 60 years, hypertension control rates were higher in men than in women. Factors decreasing hypertension control were white-collared women and young age, alcohol consumption in men. Sex differences in hypertension prevalence and control were discovered among Korean adults. After the age of 60, females were more likely to have hypertension and less likely to maintain hypertension control than males of the same age range. Accordingly, sex-specific approaches are recommended for effective blood pressure management.

Fig 1. Logit proportions of hypertension prevalence by sex and deciles of age (first) and BMI (second) for n = 27,887 subjects, along with spline fits (smooth curves).

*Cubic spline was adjusted according to sex, individual income quartile, education, occupation, alcohol intake, smoking status, and body mass index. Shaded bands are pointwise 0.95 confidence limits for predicted log odds ratio. Triangle marks: Male proportions, X marks: Female proportions.

Fig 2. Logit proportions of hypertension control by sex and deciles of age (first) and BMI (second) for n = 27,887 subjects, along with spline fits (smooth curves).

*Cubic spline was adjusted according to sex, individual income quartile, education, occupation, alcohol intake, smoking status, and body mass index. Shaded bands are pointwise 0.95 confidence limits for predicted log odds ratio. Triangle marks: Male proportions, X marks: Female proportions.