우리나라 청년, 중년, 노년 인구에서 고혈압 인지 및 치료 관련요인

Abstract

Background and Objective Recently, the increase in high blood pressure and their untreatment have emerged as problems at young ages. Although factors related to the awareness and treatment of hypertension have been reported, studies on young age groups are insufficient. Therefore, in this study, factors related to the awareness and treatment of hypertension were investigated by stratifying the age group into youth, middle-aged, and old age. Methodology The analysis was conducted using data from the 7th National Health and Nutrition Survey (2016-2018) and the 8th 1st year (2019). A study was conducted on patients with hypertension over the age of 20. Patients with hypertension were defined as those with systolic blood pressure of 140 mmHg or more, diastolic blood pressure of 90 mmHg or more, or currently taking hypertensive drugs. 7,420 people with hypertension were selected as the final analysis subjects. The analysis was stratified into 463 young people (20-39 years old), 2,296 middle-aged people (40-59 years old), and 4,661 elderly people (60 years old or older), and chi-square analysis and logistic regression analysis were conducted to find out the factors related to hypertension awareness and treatment rate. Result The prevalence of hypertension is 7.5% in the youth group, 26.5% in the middle-aged group, and 58.4% in the elderly group. The awareness rate of hypertension was 19.2% in the youth group, 60.1% in the middle-aged group, and 84.5% in the elderly group. The treatment rate for hypertension was 15.3% in the youth group, 55.3% in the middle-aged group, and 81.6% in the elderly group. First, looking at the awareness of hypertension and related factors in all age groups, as the age increased by 1 year, the awareness rate of hypertension was 1.07 times higher in the youth group(OR 1.07, 95% CI 1.01-1.14), 1.10 times higher in the middle-aged group(OR 1.10, 95% CI 1.08-1.12), 1.07 times higher in the elderly group(OR 1.07, 95% CI 1.05-1.09). When subjective health perception was ‘very bad/bad’, it was 6.01 times for the youth group(OR 6.01, 95% CI 2.39-15.10), 1.46 times for the middle-aged group(OR 1.46, 95% CI 1.08-1.99), and 1.86 times for the elderly group(OR 1.86, 95% CI 1.43-2.42), When dyslipidemia was diagnosed, the awareness rate of hypertension was 18.14 times higher in the youth group(OR 18.14, 95% CI 7.16-45.92), 4.47 times higher in the middle-aged group(OR 4.47, 95% CI 3.51-5.69), and 3.16 times higher in the elderly group(OR 3.16, 95% CI 2.56-3.91). Second, looking at the treated of hypertension and related factors in all age groups, as the age increased by 1 year, the treatment rate of hypertension was 1.14 times for the youth group(OR 1.14, 95% CI 1.05-1.24), 1.10 times for the middle-aged group(OR 1.10, 95% CI 1.08-1.12), and 1.07 times for the elderly group(OR 1.07, 95% CI 1.05-1.08). When subjective health perception was ‘very bad/bad’, it was 6.23 times for the youth group(OR 6.23, 95% CI 2.12-18.31) and 1.74 times for the elderly group(OR 1.74, 95% CI 1.37-2.22), and when dyslipidemia was diagnosed, the youth group 28.55 times(OR 28.55, 95% CI 10.63-76.70), the middle-aged group 3.82 times(OR 3.82, 95% CI 3.06-4.78), It was 2.97 times for the elderly group(OR 2.87, 95% CI 2.45-3.60). In the case of diabetes diagnosis, the treatment rate for hypertension was 6.12 times higher in the youth group(OR 6.12, 95% CI 1.19-31.49), 3.79 times higher in the middle-aged group(OR 3.79, 95% CI 2.62-5.49), and 2.48 times higher in the elderly group(OR 2.48, 95% CI 1.96-3.15). Conclusion The young age group in their 20s and 30s had lower hypertension awareness and treatment rates than other age groups. They recognize and treat high blood pressure when they are in poor subjective health and have diseases such as dyslipidemia, but if they do not have accompanying diseases, they are considered to have limited treatment opportunities. Active hypertension management strategies are needed for young age groups in their 20s and 30s, and when high blood pressure is suspected in the national health examination blood pressure measurement, follow-up management and treatment linkage systems will be needed.

배경 및 목적 최근 젊은 연령에서 고혈압 증가와 이들의 비치료가 문제로 대두되었다. 고혈압 인지 및 치료 관련요인에 대해 보고되어 왔으나, 젊은 연령층 대상 연구는 충분하지 않다. 이에 본 연구에서는 청년, 중년, 노년으로 연령층을 층화하여 고혈압 인지 및 치료 관련요인을 알아보았다. 연구방법 국민건강영양조사 제7기(2016년-2018년), 제8기 1차년도(2019년)자료로 만 20세 이상 고혈압 유병자를 대상으로 연구를 수행하였다. 고혈압 유병자는 수축기혈압이 140mmHg 이상 또는 이완기혈압이 90mmHg 이상 또는 현재 고혈압 약물을 복용하고 있는 사람으로 정의하였다. 고혈압 유병자 7,420명을 최종 분석대상자로 선정하였다. 청년군(20-39세) 463명, 중년군(40-59세) 2,296명, 노년군(60세 이상) 4,661명으로 층화하여 분석하였으며, 고혈압 인지율 및 치료율 관련요인을 알아보기 위하여 카이제곱분석과 로지스틱 회귀분석을 실시하였다. 연구결과 고혈압 유병률은 청년군 7.5%, 중년군 26.5%, 노년군 58.4%, 고혈압 인지율은 청년군 19.2%, 중년군 60.1%, 노년군 84.5%이었다. 고혈압 치료율은 청년군 15.3%, 중년군 55.3%, 노년군 81.6%이었다. 고혈압 인지 여부 관련요인을 보면, 연령이 1세 증가할수록 고혈압 인지율은 청년군 1.07배(OR 1.07, 95% CI 1.01-1.14), 중년군 1.10배(OR 1.10, 95% CI 1.08-1.12), 노년군 1.07배(OR 1.07, 95% CI 1.05-1.09) 높았다. 주관적 건강인지가‘매우나쁨/나쁨’인 경우 청년군 6.01배(OR 6.01, 95% CI 2.39-15.10), 중년군 1.46배(OR 1.46, 95% CI 1.08-1.99), 노년군 1.86배(OR 1.86, 95% CI 1.43-2.42)이었으며, 이상지질혈증을 진단받은 경우 청년군 18.14배(OR 18.14, 95% CI 7.16-45.92), 중년군 4.47배(OR 4.47, 95% CI 3.51-5.69), 노년군 3.16배(OR 3.16, 95% CI 2.56-3.91) 고혈압 인지율이 높았다. 고혈압 치료 여부 관련요인을 보면, 연령이 1세 증가할수록 고혈압 치료율은 청년군 1.14배(OR 1.14, 95% CI 1.05-1.24), 중년군 1.10배(OR 1.10, 95% CI 1.08-1.12), 노년군 1.07배(OR 1.07, 95% CI 1.05-1.08)이었다. 주관적 건강인지가‘매우 나쁨/나쁨’인 경우 청년군 6.23배(OR 6.23, 95% CI 2.12-18.31), 노년군 1.74배(OR 1.74, 95% CI 1.37-2.22)이었으며, 중년군에서는 유의한 차이를 보이지 않았다. 이상지질혈증을 진단 받은 경우 고혈압 치료율이 청년군 28.55배(OR 28.55, 95% CI 10.63-76.70), 중년군 3.82배(OR 3.82, 95% CI 3.06-4.78), 노년군 2.97배(OR 2.97, 95% CI 2.45-3.60) 높았으며, 당뇨병을 진단 받은 경우 청년군 6.12배(OR 6.12, 95% CI 1.19-31.49), 중년군 3.79배(OR 3.79, 95% CI 2.62-5.49), 노년군 2.48배(OR 2.48, 95% CI 1.96-3.15) 높았다. 건강검진 수검 시 청년군에서 1.75배(OR 1.75, 95% CI 0.94-3.24), 중년군에서 1.30배(OR 1.30, 95% CI 1.04-1.63), 노년군에서 1.23배(OR 1.23, 95% CI 1.02-3.66)로 고혈압 인지율이 높았는데, 청년군에서는 유의하지 않았다. 결론 20-30대 젊은 연령군은 고혈압 인지율과 치료율이 다른 연령군에 비해 낮았다. 이들은 주관적 건강 상태가 좋지 않을 때와 이상지질혈증과 같은 질환이 있어 병원을 이용하는 경우에 고혈압을 인지, 치료하게 되나, 동반 질환이 없는 경우 오히려 치료 기회가 제한된 것으로 생각된다. 20-30대 젊은 연령군에 대한 적극적인 고혈압 관리 전략이 필요하며, 국가건강검진 혈압 측정에서 고혈압 의심 시 사후관리와 치료 연계체계에 대한 고려가 필요할 것이다.