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Association of blood pressure measurements in sitting, supine, and standing positions with the 10-year risk of mortality in Korean adults
Inkyung Baik, Nan Hee Kim, Seong Hwan Kim, Chol Shin
Epidemiol Health. 2023;45:e2023055.   Published online June 8, 2023
DOI: https://doi.org/10.4178/epih.e2023055
  • 10,927 View
  • 231 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This prospective cohort study investigated the association between blood pressure (BP) as measured in different body postures and all-cause and cardiovascular (CV) mortality risk.
METHODS
This population-based investigation included 8,901 Korean adults in 2001 and 2002. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured sequentially in the sitting, supine, and standing positions and classified into 4 categories: (1) normal, SBP <120 mmHg and DBP <80 mmHg; (2) high normal/prehypertension, SBP 120-129 mmHg and DBP <80 mmHg/SBP 130-139 mmHg or DBP 80-89 mmHg; (3) grade 1 hypertension (HTN), with SBP 140-159 mmHg or DBP 90-99 mmHg; and (4) grade 2 HTN, SBP ≥160 mmHg or DBP ≥100 mmHg. The date and cause of individual deaths were confirmed in the death record data compiled until 2013. Data were analyzed using Cox proportional hazard regression.
RESULTS
Significant associations were found between the BP categories and all-cause mortality, but only when BPs were measured in the supine position. The multivariate hazard ratios (95% confidence intervals, [CIs]) were 1.36 (95% CI, 1.06 to 1.75) and 1.59 (95% CI, 1.06 to 2.39) for grade 1 HTN and grade 2 HTN, respectively, compared with the normal category. The associations between the BP categories and CV mortality were significant regardless of body posture among participants ≥65 years, whereas they were significant for supine BP measurements only in those <65 years.
CONCLUSIONS
BP measured in the supine position predicted all-cause mortality and CV mortality better than BP measured in other postures.
Summary
Korean summary
본 역학 연구는 한국 성인 8,901명을 연구대상자로 하여 기초조사에서 세가지 자세, 즉 앉은 자세, 누운 자세, 일어선 자세에서 혈압을 측정하고, 이후 10년 동안의 사망 여부를 추적조사하여, 측정 자세에 따른 혈압과 사망 위험과의 관련성을 분석하였다. 그 결과, 누운 자세에서 측정된 고혈압(기준: 수축기 혈압이 140 mmHg 이상 혹은 이완기 혈압이 90 mmHg 이상)인 사람은 정상 혈압(기준: 수축기 혈압이 120 mmHg 미만이고 이완기 혈압이 80 mmHg 미만)인 사람에 비해 36%(1단계 고혈압) 혹은 59%(2단계 고혈압) 가량 총 사망 위험이 유의적으로 증가하는 것으로 나타났다. 이에 비해, 앉은 자세 및 일어선 자세에서 측정, 정의된 고혈압은 총 사망 위험을 증가시켰지만 유의적인 결과를 나타내지 못했다. 추후 연구에서 재확인이 필요하지만, 본 연구 결과가 시사하는 바는 앉은 자세나 일어선 자세보다 누운 자세에서 측정하는 혈압이 총 사망 위험을 더 잘 예측하므로, 고혈압 진단 외의 추가적인 활용 가능성이 있는 것으로 평가된다.
Key Message
The current epidemiological study revealed that blood pressure measured in a supine position could predict all-cause mortality and cardiovascular mortality better than blood pressure measured in a sitting or standing position. As a result, blood pressure measurements in a supine position may be useful in assessing mortality risk.

Citations

Citations to this article as recorded by  
  • Safety of midodrine in patients with heart failure with reduced ejection fraction: a retrospective cohort study
    Ming-Ju Wu, Cheng-Hsu Chen, Shang-Feng Tsai
    Frontiers in Pharmacology.2024;[Epub]     CrossRef
Association between body temperature and leukocyte telomere length in Korean middle-aged and older adults
Carolina García-García, Chol Shin, Inkyung Baik
Epidemiol Health. 2021;43:e2021063.   Published online September 8, 2021
DOI: https://doi.org/10.4178/epih.e2021063
  • 11,530 View
  • 215 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Data on associations between body temperature (BT) and leukocyte telomere length (LTL), which has been widely used as a biomarker of cellular senescence in recent epidemiological studies, are limited. Therefore, this study aimed to explore the associations between a normal BT range (35.0-37.5°C) and LTL via 6-year longitudinal observations of 2,004 male and female adults aged 50 or older.
METHODS
BT was obtained by measuring the tympanic temperature, and relative LTL was determined by real-time polymerase chain reaction. Robust regression analysis was used to evaluate the association between the baseline and follow-up LTL values and their differences.
RESULTS
A significant inverse association was found between BT and LTL at baseline. The regression coefficient estimate was -0.03 (95% confidence interval, -0.07 to -0.001; p<0.05). This association was stronger in participants with a body mass index >25 kg/m<sup>2</sup> and males (p<0.01). However, there were no associations between BT and LTL at follow-up or BT and 6-year longitudinal differences in LTL.
CONCLUSIONS
These findings suggest that having a high BT between 35°C and 37.5°C (95°F and 99°F) may be detrimental for obese individuals in terms of biological aging.
Summary
Korean summary
본 역학 연구는 한국 성인 2,004명을 연구대상자로 하여 2011-2012년에 고막 체온을 측정하고 전혈을 채취하여 백혈구 텔로미어 길이를 분석하였으며 이러한 분석을 2017-2018년에 반복하여 6년 동안의 백혈구 텔로미어 길이 변화를 계산하였다. 고막 체온과 초기 텔로미어 길이의 관련성을 분석한 결과, 정상 체온 범위 내 체온이 높을수록 텔로미어 길이가 유의적으로 짧아지는 생리적 노화 상태와 관련된 것으로 나타났으며, 이러한 결과는 비만할 경우 더욱 분명하게 나타났다. 본 연구 결과를 통해 비만 시 체내 열발생과 관련된 노화 진행이 체중 감소를 통해 지연될 수 있는 가능성이 제시되었다.
Key Message
In an epidemiological study including Korean adults, a relatively higher normal body temperature between 35°C to 37.5°C was found to be associated with shorter leukocyte telomere length, a cellular senescence biomarker. In particular, this association was observed to be stronger among obese participants, suggesting that attaining normal body weight may be beneficial for anti-aging.

Citations

Citations to this article as recorded by  
  • Higher Daily Air Temperature Is Associated with Shorter Leukocyte Telomere Length: KORA F3 and KORA F4
    Wenli Ni, Kathrin Wolf, Susanne Breitner, Siqi Zhang, Nikolaos Nikolaou, Cavin K. Ward-Caviness, Melanie Waldenberger, Christian Gieger, Annette Peters, Alexandra Schneider
    Environmental Science & Technology.2022; 56(24): 17815.     CrossRef

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