韩国中风幸存者血管危险因素控制的全国趋势：基于2010年至2021年全国健康与营养检查调查
National Trends of Vascular Risk Factor Control Among Stroke Survivors in Korea: From the National Health and Nutrition Examination Survey 2010 to 2021.
作者信息
Lee Eung-Joon, Jeong Han-Yeong, Jung Keun-Hwa
机构信息
Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Institute of Public Health and Care, Seoul National University Hospital, Seoul, Korea.
出版信息
J Korean Med Sci. 2025 May 26;40(20):e74. doi: 10.3346/jkms.2025.40.e74.
BACKGROUND
To prevent stroke recurrence in stroke survivors, effective management of vascular risk factors (VRFs), including hypertension, diabetes, hyperlipidemia, and smoking, is essential. This study aimed to assess the VRF control status and trends among stroke survivors in Korea.
METHODS
This cross-sectional study analyzed data from 1,261 stroke survivors aged ≥ 19 years (mean age: 65.2 years; 43.1% female) who were part of the Korea National Health and Nutrition Examination Survey from 2010 to 2021. The control status of VRFs was evaluated using standardized criteria: hypertension (blood pressure < 140/90 mmHg), diabetes (hemoglobin A1c < 7%), hyperlipidemia (low-density lipoprotein cholesterol [LDL-C] < 70 mg/dL), and smoking status. Multivariate logistic regression analysis was conducted to identify factors associated with uncontrolled VRFs.
RESULTS
The rates of age-adjusted hypertension, diabetes, and smoking control remained consistent throughout the observation period. However, overall LDL-C control improved from 30.1% in 2010-2012 to 40.4% in 2019-2021 ( = 0.015), particularly in those aged ≥ 65 years. However, in the 19-49 age group, the control rate decreased from 47.0% to 15.8% ( = 0.048). Smoking rates showed no significant improvement (70.2% in 2019-2021 compared to 69.6% in 2010-2012), particularly among men. Living alone (adjusted odds ratio [aOR], 1.85; 95% confidence interval [CI], 1.03-3.32) was significantly associated with uncontrolled hypertension, whereas living in urban areas was linked to uncontrolled diabetes (aOR, 2.75; 95% CI, 1.06-7.17). Non-health screening was significantly associated with uncontrolled hyperlipidemia (aOR, 2.28; 95% CI, 1.25-4.14), and men were more likely to continue smoking (aOR, 4.47; 95% CI, 3.12-6.72).
CONCLUSION
These findings highlight the need for targeted health strategies to enhance risk-factor management and reduce stroke recurrence.
背景
为预防卒中幸存者再次发生卒中，有效管理血管危险因素（VRF）至关重要，这些因素包括高血压、糖尿病、高脂血症和吸烟。本研究旨在评估韩国卒中幸存者的VRF控制状况及趋势。
方法
这项横断面研究分析了2010年至2021年韩国国家健康与营养检查调查中1261名年龄≥19岁的卒中幸存者（平均年龄：65.2岁；43.1%为女性）的数据。使用标准化标准评估VRF的控制状况：高血压（血压<140/90 mmHg）、糖尿病（糖化血红蛋白<7%）、高脂血症（低密度脂蛋白胆固醇[LDL-C]<70 mg/dL）和吸烟状况。进行多变量逻辑回归分析以确定与VRF未得到控制相关的因素。
结果
在整个观察期内，年龄调整后的高血压、糖尿病和吸烟控制率保持一致。然而，总体LDL-C控制率从2010 - 2012年的30.1%提高到2019 - 2021年的40.4%（P = 0.015），尤其是在年龄≥65岁的人群中。然而，在19 - 49岁年龄组中，控制率从47.0%降至15.8%（P = 0.048）。吸烟率没有显著改善（2019 - 2021年为70.2%，而2010 - 2012年为69.6%），尤其是在男性中。独居（调整后的优势比[aOR]，1.85；95%置信区间[CI]，1.03 - 3.32）与高血压未得到控制显著相关，而居住在城市地区与糖尿病未得到控制有关（aOR，2.75；95% CI，1.06 - 7.17）。未进行健康筛查与高脂血症未得到控制显著相关（aOR，2.28；95% CI，1.25 - 4.14），男性更有可能继续吸烟（aOR，4.47；95% CI，3.12 - 6.72）。
结论
这些发现凸显了制定有针对性的健康策略以加强危险因素管理和降低卒中复发率的必要性。
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