Comparison of triglyceride-glucose index and HOMA-IR for predicting prevalence and incidence of metabolic syndrome.

BACKGROUND AND AIMS: Insulin resistance is related closely to metabolic syndrome (MetS). The homeostasis model assessment of insulin resistance (HOMA-IR) is the most commonly used insulin resistance index, but the triglyceride-glucose (TyG) index has been suggested as a reliable alternative insulin resistance index. This study aims to compare the predictive powers of TyG index and HOMA-IR for the prevalence and incidence of MetS in a large, community-based, prospective cohort over 12 years of follow-up. METHODS AND RESULTS: Data from 9730 adults with or without MetS at baseline, 6091 adults without MetS who were followed as part of the Korean Genome and Epidemiology Study were analyzed. Receiver-operating-characteristic (ROC) curves and time-dependent ROC curves were performed to compare the areas under the ROC curve (AUROC) of the TyG index and HOMA-IR for predicting the prevalence and incidence of MetS. The optimal cut-off points were calculated. Cox proportional hazard spline curves were used to verify dose-response relationship between TyG index/HOMA-IR and incident MetS. TyG index showed higher predictive power for prevalent MetS than HOMA-IR (0.837 vs. 0.680, p < 0.001). The AUROC for incident MetS of TyG index and HOMA-IR was 0.654 (0.644-0.664) and 0.556 (0.531-0.581), respectively (p < 0.001). Cut-off points of TyG index and HOMA-IR for predicting the prevalence of MetS were 8.718 and 1.8 and for predicting incident MetS were 8.518 and 1.5, respectively. Both TyG index and HOMA-IR had a linear relationship with incident MetS. CONCLUSIONS: TyG index is superior to HOMA-IR for predicting MetS.

Long-term clinical study and multiscale analysis of in vivo biodegradation mechanism of Mg alloy.

There has been a tremendous amount of research in the past decade to optimize the mechanical properties and degradation behavior of the biodegradable Mg alloy for orthopedic implant. Despite the feasibility of degrading implant, the lack of fundamental understanding about biocompatibility and underlying bone formation mechanism is currently limiting the use in clinical applications. Herein, we report the result of long-term clinical study and systematic investigation of bone formation mechanism of the biodegradable Mg-5wt%Ca-1wt%Zn alloy implant through simultaneous observation of changes in element composition and crystallinity within degrading interface at hierarchical levels. Controlled degradation of Mg-5wt%Ca-1wt%Zn alloy results in the formation of biomimicking calcification matrix at the degrading interface to initiate the bone formation process. This process facilitates early bone healing and allows the complete replacement of biodegradable Mg implant by the new bone within 1 y of implantation, as demonstrated in 53 cases of successful long-term clinical study.

Neck Circumference as a Predictor of Insulin Resistance in People with Non-alcoholic Fatty Liver Disease.

Background: Insulin resistance is common in individuals with non-alcoholic fatty liver disease (NAFLD). Because insulin resistance is a predictive factor for advanced liver diseases in people with NAFLD, efforts have been made to predict it through anthropometric variables. Recently, neck circumference (NC) has been regarded as a reliable alternative marker for metabolic disorders. This study verified the association between NC and insulin resistance in patients with NAFLD. Methods: We analyzed data from 847 people with NAFLD who participated in the 2019 Korean National Health and Nutrition Examination Survey. NAFLD was defined by a hepatic steatosis index score of ≥36 points, and insulin resistance was defined by a homeostatic model assessment of insulin resistance score of ≥2.5 points. Participants were divided according to sex-specific NC tertiles (T1, lowest; T2, middle; T3, highest). Results: In the analysis of the area under the receiver operating characteristic curve (AUC), NC displayed a greater predictive power than body mass index (BMI) for insulin resistance in women (AUC of NC=0.625 vs. AUC of BMI=0.573, P=0.035). NC and the odds ratio (OR) for insulin resistance showed a cubic relationship in both men and women. In the weighted multiple logistic regression analysis, the ORs with 95% confidence intervals for insulin resistance in people with NAFLD in T2 and T3 compared to the reference tertile (T1) were 1.06 (0.47-2.41) and 1.13 (0.41-3.11), respectively, in men and 1.12 (0.64-1.97) and 2.54 (1.19-5.39), respectively, in women, after adjusting for confounding factors. Conclusion: NC was positively correlated with insulin resistance in women with NAFLD.

Perceived Importance and Performance of Critical Care Nursing Competency by Nurses' Clinical Expertise.

Background and Purpose: To enhance critical care competency, it is necessary to develop and apply a clinical expertise-based competency training program. This study aimed to identify the perceived importance and performance of critical care nursing competency and the training priorities of competency-based training programs by nurses' clinical expertise. Methods: This was a cross-sectional descriptive survey with a convenience sample of 236 intensive care unit nurses. The critical care nursing competency of nurses was measured. Training needs were determined using an importance-performance analysis. Results: Competency areas with high training priority on the importance-performance matrix were skin assessment, emotional support, Code of Ethics, and collaboration for novice nurses, skin assessment and patient education for advanced beginner nurses, skin assessment and decision-making for competent nurses, and patient education and interprofessional collaboration for proficient nurses. Implications for Practice: Different training needs were identified according to the self-reported level of clinical expertise at four levels. Nursing administrators and educators should provide competency-based continuing education programs based on high-priority training areas according to the nurses' clinical expertise.

Inverse Relationship between Serum 25-Hydroxyvitamin D and Elevated Intraocular Pressure.

Elevated intraocular pressure (EIOP) is the only major modifiable risk factor of glaucoma. While low serum vitamin D levels are considered a potential risk factor for glaucoma, there is conflicting evidence on the relationship between vitamin D and EIOP despite the possible linkage between vitamin D and intraocular pressure through oxidative stress and systemic inflammation. Therefore, the aim of this study is to verify the relationship between 25-hydroxyvitamin D [25(OH)D] and EIOP using data from 15,338 individuals who visited the health promotion center of an education hospital. The cubic spline curve revealed an inverse dose-dependent association between serum 25(OH)D level and EIOP. Using multiple logistic regression analysis, the fully adjusted odds ratio (OR) with 95% confidence interval (CI) for the EIOP of the serum 25(OH)D per increment was 0.97 (0.96-0.990). The fully adjusted ORs (95% CIs) for the EIOP of the 25(OH)D insufficiency and 25(OH)D sufficiency groups, compared to 25(OH)D deficiency group, were 0.72 (0.56-0.92) and 0.51 (0.34-0.78), respectively. The relationship remained significant in male and young age subgroups. In conclusion, the clinical assessment of intraocular pressure may prove helpful when treating patients with 25(OH)D deficiency, which may be a preventive strategy against the development of glaucoma.

A Positive Association between the Atherogenic Index of Plasma and White Matter Hyperintensity.

BACKGROUND: White matter hyperintensity (WMH) is a risk factor for dementia and ischemic stroke. The atherogenic index of plasma (AIP) is a simple and cost-effective marker for the prediction of various vascular diseases. In this study, we evaluated the relationship between AIP and WMH in adults without cerebrovascular accidents. METHODS: We analyzed the data of 281 adults, aged ≥26 years, who underwent brain magnetic resonance imaging (MRI) at the health promotion center of an education hospital between January 2014 and December 2018. Participants were divided into three categories according to tertiles of the AIP scores (T1: <0.20; T2: 0.20-0.48; and T3: >0.48). WMH was defined as a modified Fazekas scale score of 1-3 on brain MRI. A cubic spline curve was used to determine the linearity of the relationship between AIP and WMH. Multiple logistic regression analysis was used to evaluate the relationship between the AIP and WMH. RESULTS: The prevalence of WMH was 45.7% in T1, 57.0% in T2, and 66.0% in T3 (T3 vs. T1, P for post-hoc analysis=0.005). The increased odds of WMH were associated with increased AIP. The odds ratio (OR) with a 95% confidence interval (CI) for WMH of T2 and T3 compared with T1 were 1.57 (0.88-2.80) and 2.30 (1.28-4.14), respectively. After adjusting for confounding variables, the OR with a 95% CI for WMH in the T2 and T3 groups vs. the referent T1 were 1.55 (0.76-3.13) and 2.27 (1.06-4.84), respectively. CONCLUSION: AIP is independently and positively associated with WMH in a healthy population.

Metabolic Score for Insulin Resistance Is Inversely Related to Incident Advanced Liver Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease.

We determined the relationships between metabolic score for IR (METS-IR), triglyceride-glucose (TyG) index, and homeostatic model assessment for IR (HOMA-IR) and incident advanced liver fibrosis (ALF) and assessed the abilities of the three IR indicators to predict ALF in patients with non-alcoholic fatty liver disease (NAFLD) in adults with NAFLD who were aged 40-69 years old. Among 2218 participants with NAFLD at baseline, the areas under the receiver operating characteristic curve for predicting ALF of the METS-IR was 0.744 (0.679-0.810), significantly higher than that of TyG index (0.644 (0.569-0.720)) or that of HOMA-IR (0.633 (0.556-0.710)). Among 1368 patients with NAFLD and without ALF at baseline, 260 (19.0%) patients with NAFLD progressed to ALF during the 16-year follow-up period. Multivariable Cox proportional hazard regression analysis revealed that the adjusted hazard ratio (95% confidence interval) for incident ALF in the highest tertiles of METS-IR, TyG index, and HOMA-IR compared with the lowest tertile of each IR indicator were 0.5 (0.36-0.91), 0.7 (0.49-1.00), and 1.01 (0.71-1.42), respectively. METS-IR was inversely associated with ALF in patients with NAFLD, which cautiously suggests that the risk of ALF may need to be evaluated when metabolic parameters improve in individuals with NAFLD.

Fatty Liver Is an Independent Risk Factor for Elevated Intraocular Pressure.

Elevated intraocular pressure (EIOP) is a major risk factor for glaucoma. Both EIOP and fatty liver share metabolic risk factors, which implies a possible link between EIOP and fatty liver. We aimed to determine the association of fatty liver with EIOP and estimate the effect of fatty liver on EIOP directly and indirectly through insulin resistance. Data from 16,240 adults who underwent health examinations at a single center were analyzed. Multiple logistic regression analyses revealed that fully adjusted odds ratio (OR) and 95% confidence interval (CI) for EIOP in the fatty liver group compared to the non-fatty liver group were 1.36 and 1.08-1.71. Alcoholic liver disease was associated with EIOP in subgroup analysis (OR = 1.80, 95% CI: 1.27-2.56). There was a linear dose-response relationship between EIOP and the severity of fatty liver. Mediation analysis revealed that the total effect of fatty liver on intraocular pressure was 0.90 (0.81-0.99), with a direct effect of 0.81 (0.71-0.90) and an indirect effect of 0.09 (0.06-0.11) through insulin resistance. Fatty liver is independently associated with EIOP. It primarily has a direct effect on intraocular pressure. This suggests that evaluation of EIOP should be considered in patients with fatty liver.

The usefulness of metabolic score for insulin resistance for the prediction of incident non-alcoholic fatty liver disease in Korean adults.

BACKGROUND/AIMS: The early detection and prevention of non-alcoholic fatty liver disease (NAFLD) has been emphasized considering the burden of this disease. Both hepatic and peripheral insulin resistances are strongly associated with NAFLD. We aimed to compare the predictive powers of a hepatic insulin resistance index, the homeostatic model assessment for insulin resistance (HOMA-IR), and a novel peripheral insulin resistance index, the metabolic score for insulin resistance (METS-IR), for the prediction of prevalent and incident NAFLD. METHODS: Data from 8,360 adults aged 40-69 years at baseline and 5,438 adults without NAFLD who were followed-up at least once after the baseline survey in the Korean Genome and Epidemiology Study were analyzed. The survey was performed biennially, up to the eighth follow-up. RESULTS: The predictive powers of the METS-IR and HOMA-IR for prevalent NAFLD were not significantly different (area under the receiver operating characteristic [ROC] curve [95% confidence interval]: METS-IR, 0.824 [0.814-0.834]; HOMAIR, 0.831 [0.821-0.842]; P=0.276). The area under the time-dependent ROC curve (Heagerty's integrated area under the curve) of the METS-IR for incident NAFLD was 0.683 (0.671-0.695), significantly higher than that of the HOMA-IR (0.551 [0.539-0.563], P<0.001). CONCLUSION: The METS-IR is superior to the HOMA-IR for the prediction of incident NAFLD and is not inferior to the HOMA-IR for the prediction of prevalent NAFLD. This suggests that the METS-IR can be a more useful insulin resistance index than the HOMA-IR for the early detection and prevention of NAFLD in Korean population.

Biocompatibility evaluation of peo-treated magnesium alloy implants placed in rabbit femur condyle notches and paravertebral muscles.

BACKGROUND: Magnesium alloys have been receiving much attention for use in biodegradable metal implants because of their excellent mechanical properties and biocompatibility. However, their rapid breakdown and low bioactivity can cause the implant to lose mechanical integrity before the bone is completely healed. Moreover, hydrogen gas released during degradation can significantly delay the tissue regeneration process. To solve the instability of magnesium alloys, Zn and Ca can be added to improve the mechanical properties and biocompatibility. One other way to improve the mechanical properties of Mg is plasma electrolytic oxidation (PEO), which provides a dense, thick ceramic-like coating on the Mg surface. In this study, high-purity Mg was selected as the control, and Mg-1wt%Zn-0.1wt%Ca alloy and PEO-treated Mg-1wt%Zn-0.1wt%Ca alloy were selected as the test materials; the results of radiographic and histological analyses of their biocompatibility are reported herein. MATERIALS AND METHOD: Nineteen New Zealand white rabbits were used in the study. Rod-bars (Ø2.7 × 13.6 mm) were placed on both paravertebral muscles, and cannulated screws (Ø2.7x10mm) were placed on both femur condyle notches. Each animal was implanted in all four sites. X-rays were taken at 0, 2, 4, 8, and 12 weeks, micro-CT, and live-CT were taken at 4, 8, and 12 weeks. At weeks 4, 8, and 12, individuals representing each group were selected and sacrificed to prepare specimens for histopathological examination. RESULT: The results confirm that in vivo, Mg-1wt%Zn-0.1wt%Ca alloy had higher corrosion resistance than high-purity Mg and safely degraded over time without causing possible side effects (foreign body or inflammatory reactions, etc.). In addition, PEO treatment of Mg-1wt%Zn-0.1wt%Ca alloy had a positive effect on fracture recovery by increasing the bonding area with bone. CONCLUSION: Our results suggest that PEO treatment of Mg-1wt%Zn-0.1wt%Ca alloy can be a promising biomaterials in the field of various clinical situations such as orthopedic and maxillofacial surgerys.

Teamwork, psychological safety, and patient safety competency among emergency nurses.

INTRODUCTION: The patient safety competency of emergency nurses is critical because the emergency department is a complex and dynamic setting in which patient safety incidents are likely to occur owing to difficulties in controlling and predicting situations. PURPOSE: This study aimed to identify factors that predict the patient safety competency of emergency nurses. METHODS: A descriptive correlational study using cross-sectional survey methodology was conducted with a convenience sample of 200 emergency nurses. Teamwork, psychological safety, and patient safety competency were measured using a self-administered questionnaire. Data were analyzed using descriptive statistics, Pearson's correlation, and stepwise multiple regression. RESULTS: Multiple regression analysis revealed that situation monitoring, reporting of patient safety adverse events, number of night shifts per month, and psychological safety were significant factors affecting patient safety competency, accounting for 27.1% of the variance. CONCLUSIONS: A training program targeting emergency nurses with vulnerable factors is needed to improve their patient safety competency. As situation monitoring and psychological safety were found to be influential factors for patient safety competency, multi-level intervention is needed to improve nurses' situation monitoring ability and psychological safety.

The Relationship between Heart Rate Variability and Aortic Knob Width.

BACKGROUND: The aortic knob width (AKW) and the heart rate variability (HRV) were suggested to be related to development of cardiovascular diseases. However, the relationship between them has not been investigated; thus, this study aimed to determine this relationship. METHODS: This study included 587 Koreans aged 18-79 years. Their physical measurements, medical and social histories, blood test findings, and chest radiographs were obtained. The HRV parameters included the standard deviation of the N-N interval (SDNN), root mean square of successive differences (RMSSD), approximate entropy (ApEn), total power (TP), very low frequency (VLF), low frequency (LF), high frequency (HF), and LF/HF ratio, which were measured for 5 minutes. The AKW was measured on chest radiographs by a single reviewer. RESULTS: The AKW was significantly correlated with the HRV parameters, except for the LF/HF ratio. However, RMSSD and ApEn were not significantly related to the AKW in women. After dividing the participants into quartile groups, the AKW was significantly related to the SDNN, RMSSD, TP, VLF, LF, and HF. The HRV parameter values decreased in the higher AKW quartile groups, the HRV parameter values decreased. After adjusting for sex, drinking status, exercise habits, smoking status, waist circumference, and triglyceride, low-density lipoprotein cholesterol, fasting blood sugar, and glycated hemoglobin levels, the AKW showed significant negative associations with the HRV parameters, except for the LF/HF ratio. CONCLUSION: The AKW is significantly associated with the HRV parameters of SDNN, RMSSD, ApEn, TP, VLF, LF, and HF.

Association between low thigh fat and non-alcoholic fatty liver disease.

BACKGROUND AND AIM: Some people have a fatty liver despite having low visceral fat and a low body mass index (BMI). We investigated whether fat distribution, especially thigh subcutaneous fat and thigh intramuscular fat, is associated with non-alcoholic fatty liver disease (NAFLD). METHODS: The patients consisted of 408 men and women. NAFLD was defined by an ultrasound scan and excluded other liver diseases. Visceral, subcutaneous abdominal, intramuscular, and subcutaneous thigh adipose tissue was measured by computed tomography. RESULTS: The frequency of NAFLD decreased over a quartile of thigh fat independently of BMI in the female patients. Additional adjustments for age and visceral fat area did not change the results. This finding was not observed in the male patients. To investigate the relationship between each fat distribution and NAFLD, we performed a logistic regression analysis. Fat distribution was divided into four groups: visceral fat, abdominal subcutaneous fat, thigh subcutaneous fat, and thigh intramuscular fat. All four fat components were chosen as variables for the regression model. Age, BMI, and the homeostasis model assessment (HOMA) index were then adjusted successively. A larger subcutaneous fat area was negatively associated with NAFLD after adjustment for visceral fat and abdominal subcutaneous fat areas in women, but not in men. It did not change even after age adjustment, BMI, and the HOMA index. CONCLUSION: Low femoral subcutaneous fat amounts were shown to be independently associated with fatty liver disease in women. These results show the importance of accurate measurements of other regional body compositions as well as visceral fat amounts when investigating NAFLD.

Induction of apoptosis by a stilbene analog involves Bax translocation regulated by p38 MAPK and Akt.

trans-Stilbenes have been reported to induce cytochrome P450 1B1 (CYP1B1) inhibition and cell death, however, the molecular mechanisms of the effects are not fully understood. We report here that (1-(2-{3-[2-(2,4-dimethoxy-phenyl)-vinyl]-5-methoxy-phenoxy}ethyl)-1H-imidazole), a synthetic stilbene analog (SA) significantly suppressed TCDD-stimulated CYP1B1 mRNA expression. In HL-60 cells, SA induced apoptosis through activation of p38 MAPK and inactivation of Akt, which in turn activated Bad and mitochondrial death signaling pathway, as evidenced by Bax translocation and cytochrome c release. Expression of dominant negative p38 MAPK or constitutively active Akt significantly prevented cell death and mitochondrial Bax translocation, implicating that p38 MAPK and Akt signaling pathways play crucial roles in stilbene-induced apoptosis of HL-60 cells. These results suggest that SA induces apoptotic cell death as well as CYP1B1 inhibition and may thus be beneficial in cancer prevention.

The Relationship between Aortic Knob Width and Metabolic Syndrome.

BACKGROUND: Both aortic knob width and metabolic syndrome are suggested to be related to atherosclerosis and cardiovascular diseases. However, the association between aortic knob width and metabolic syndrome is unknown. This study aimed to explore this relationship. METHODS: Participants were 3,705 Korean adults aged 18-79 years who visited the health promotion center of a general hospital. Data on chest radiography, physical measurements, medical and social history, and blood tests were collected. We defined metabolic syndrome according to the National Cholesterol Education Program Adult Treatment Panel III criteria. A single reviewer measured aortic knob width on chest radiography. RESULTS: Aortic knob width was significantly correlated with age; body mass index; waist circumference; systolic and diastolic blood pressures; total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting glucose, glycated hemoglobin, insulin, and uric acid levels; and homeostatic model assessment of insulin resistance values. Aortic knob width significantly increased as the number of metabolic syndrome components increased. Moreover, metabolic syndrome component values tended to increase across the quartile groups of aortic knob width after adjusting for age, exercise, smoking status, and alcohol use. Through receiver operating characteristic curve analysis, we determined the clinically useful cutoff value for aortic knob width to be 30.47 mm in premenopausal women. CONCLUSION: Aortic knob width was found to be significantly related to metabolic syndrome and its individual components.

Appropriate waist circumference cutoff points for central obesity in Korean adults.

BACKGROUND: The International Diabetes Federation consensus recently proposed a new definition for the diagnosis of metabolic syndrome, incorporating ethnically specific waist circumference (WC) cutoff points. OBJECTIVE: We investigated the ethnically appropriate WC cutoff values for central obesity in Korean adults to predict increased risk of elevated triacylglycerol, reduced HDL cholesterol, elevated blood pressure, elevated fasting plasma glucose, or two or more of these factors. DESIGN: We used data from 6561 adults, aged 20-80 years, who participated in the Korean Health and Nutritional Examination Survey of 1998, a cross-sectional health survey of a nationally representative sample of Koreans. RESULTS: Based on the receiver operating characteristic curve analysis, the WC value for predicting metabolic risk factors in Koreans was about 85 cm for men and 80 cm for women. The odds ratio for the risk of two or more metabolic risk factors increased abruptly in men with WC >or= 90 cm and women with WC >or= 85 cm. The 80th percentile for WC in the Korean population was 90 cm for men and 86.5 cm for women. Thus, the appropriate WC cutoff point for central obesity in Koreans was determined to be 90 cm for men and 85 cm for women. CONCLUSIONS: Based on our criteria, the prevalence of central obesity was 19.8% in Korean men and 24.5% in Korean women. These findings suggest the applicability of ethnically specific cutoff points for WC in assessing central obesity.

Differential gene expression by styrene in rat reproductive tissue.

Styrene is an important industrial chemical that is extensively used in the production of resins, rubbers and fiberglass-reinforced plastics. Exposing male rats to high doses of styrene may produce sperm abnormalities or infertility. To determine the mechanism underlying styrene-mediated toxicity in male reproductive organs, a reverse transcription-polymerase chain reaction (RT-PCR) technology was employed using annealing control primers (ACPs) to identify the differentially expressed genes following styrene treatment in isolated testis of male rats. By using 120 ACPs, a total of 6 expressed sequence tags (ESTs) of genes were differentially expressed in styrene-treated rats, as compared to untreated, which were cloned and sequenced. Of the genes analyzed, 5 genes (testis-specific expressed gene 101, protein kinase C, H+-ATPase isoform 2, peroxiredoxin 1, and aquaporin 9) were inducible and one gene expression (clusterin) was significantly suppressed by styrene. Regulation of each gene by styrene was confirmed by RT-PCR. It was shown that styrene decreased clusterin expression in a concentration-dependent manner and these effects occurred mainly in testis. Taken together, these results indicate that repression of clusterin gene expression by styrene may play an important role in styrene-mediated toxicities.

Prevalence of prehypertension and hypertension in a Korean population: Korean National Health and Nutrition Survey 2001.

OBJECTIVE: The present study aimed to determine the prevalence of prehypertension and hypertension, and their association with the risk factors in a Korean population. DESIGN: The Korean Nation Health and Nutrition Survey 2001, a cross-sectional survey, was a nationally representative survey in which a stratified multistage sampling design was used. METHODS: Data from a comprehensive questionnaire, together with a physical examination and blood sample, were obtained from 6074 Korean adults (2620 men and 3454 women) aged > or = 20 years, and analysed. RESULTS: The estimated age-adjusted prevalence of hypertension and prehypertension was 22.9% (26.9% in men, 20.5% in women) and 31.6% (41.9% in men, 25.9% in women), respectively, in the Korean population according to Joint National Committee 7 criteria. Multivariate analysis revealed that age, gender, body mass index, fasting plasma glucose, total-cholesterol and alcohol consumption were significantly associated with hypertension. Overall, only 30.2% of the hypertensive individuals had been previously diagnosed. Furthermore, 22.9% of the hypertensive individuals were being treated with antihypertensive medication, but only 10.7% had their blood pressure adequately controlled. The rates of awareness, treatment and control were higher for the women than for the men, and these rates increased with age. CONCLUSION: Hypertension and prehypertension are common in Korea, and more than one-half of the hypertensive patients have not been diagnosed. These results place great emphasis on the urgent need for a public health program to improve the detection, prevention and treatment of hypertension and prehypertension.