Abstract
BACKGROUND: A health check-up system (HCS) is one of the best ways to prevent complications and maintain health by diagnosing diseases and screening risk factors early. Here, we investigated how many people who detected elevated blood pressure through the HCS were finally diagnosed with "hypertension" and continuously treated. We also analyzed their cardiovascular risk and prognostic significance according to the multiple drug compliance patterns. METHODS: A total of 38,100 subjects without cardiovascular disease who were newly detected with elevated blood pressure in HCS between 2006 and 2011 were analyzed and followed up until 2019 using the Korean National Health Insurance Database. They were divided into five subgroups through subsequent prescription history and compared for epidemiological, laboratory performance and cardiovascular events. RESULTS: Of the total 38,100 subjects, 6981 (18.3%) cases were diagnosed with hypertension and started medication within 12 months. Of those cases, 3021 (7.9%) cases continued taking their medication, 2184 (5.7%) cases persistently discontinued medication, and 485 (1.3%) cases restarted medication again within 12 months of discontinuation. As a result of follow-up until 2019, the "drug-free group" showed the significantly lowest cardiovascular complication incidences (angina, heart failure, ischemic heart disease, CKD, and PAOD), and the highest were seen in the "re-initiation group" (cerebral infarct and atrial fibrillation) compared with the "continuous medication group." CONCLUSIONS: A considerable proportion of individuals with high blood pressure detected in HCS were diagnosed with hypertension and at high cardiovascular risk. The group that needed to restart medication within 12 months after discontinuation showed a higher cardiovascular risk among them.