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Kim Hyeon Chang
Journal of Hypertension: September 2016
doi: 10.1097/01.hjh.0000499873.83192.b2

Cardiovascular disease is the leading cause of death worldwide. Fortunately, cardiovascular mortality has been decreasing in high-income countries, but the rate is still increasing in some middle-income and low-income countries. Even within the Asian region, cardiovascular disease mortality is decreasing in some countries but increasing in others. However, population ageing is common to all Asian countries, and East Asia is among the most aged region in the world. Accordingly, cardiovascular disease prevention in the elderly is becoming more and more important public health issue in East Asia. Hypertension control is the key strategy for decreasing cardiovascular disease, because hypertension is the most contributing and modifiable risk factor for cardiovascular disease. Hypertension is defined as elevated systolic blood pressure (SBP) and/or elevated diastolic blood pressure (DBP). Thus it can be further classified into three subtypes; isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic-diastolic hypertension (SDH). It is known that relative frequency of ISH is increasing with age, because of progressively increasing SBP and decreasing SBP after age 60. It has been shown that SBP is more closely associated with cardiovascular risk than DBP. Moreover, there has been some evidence showing that the linear relationship between SBP and cardiovascular disease is more prominent in East Asian people than in Caucasian populations. In spite of our efforts to prevent hypertension, the absolute number of older people with hypertension, especially ISH, is expected to increase in East Asia because of the rapid population ageing. Future study of hypertension needs to be performed to find subtype-specific prevention and management strategies.

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