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  • E-ISSN 2288-3339

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Vol.40, No.3
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Association between Korean Medicine Hospital Utilization and Cardiovascular Risks in Patients with Hypertension: a National Korean Cohort Study

Journal of Korean Medicine / Journal of Korean Medicine, (P)1010-0695; (E)2288-3339
2019, v.40 no.3, pp.1-20
https://doi.org/10.13048/jkm.19024



& (2019). Association between Korean Medicine Hospital Utilization and Cardiovascular Risks in Patients with Hypertension: a National Korean Cohort Study. Journal of Korean Medicine, 40(3), 1-20, https://doi.org/10.13048/jkm.19024
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Abstract

Objectives: This study aims to investigate the effects of Korean Medicine Hospital Utilization (KMHU) on major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and death in hypertensive patients taking antihypertensives. Methods: Using the Korean National Health Insurance Service-National Sample Cohort database, this study identified and diagnosed 68,457 hypertensive patients taking antihypertensives between 2003 and 2006. They were divided into KMHU and non-KMHU groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke, or death. After propensity score matching (PSM), there were 18,242 patients each in the non-KMHU and KMHU groups. We calculated the incidence rate, hazard ratio (HR), and 95% confidence interval (CI) for MACE, myocardial infarction, stroke, and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. Results: After PSM, the HRs for MACE (HR: 0.84, 95% CI: 0.81-0.87), all-cause mortality (HR: 0.75, 95% CI: 0.72-0.79), and myocardial infarction (HR: 0.90, 95% CI: 0.83-0.97) were significantly lower in the KMHU group than in the non-KMHU group. Moreover, the HRs for stroke-related mortality, haemorrhage and ischaemic stroke-related mortality, and ischaemic heart disease-related and circulatory system disease-related mortality were significantly lower in the KMHU group than in the non-KMHU group. Conclusions: On long-term follow-up observation, this study supported the effect of KMHU for managing hypertension and reducing the burden of cardiovascular diseases.

keywords
Hypertension, Korean medicine hospital utilization, myocardial infarction, stroke, Death, National Health Insurance Service database.


Reference

1

1. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. The Lancet. 2005;365(9455):217-23.

2

2. Korea Centers for Disease Control and Prevention. The Seventh Korea National Health and Nutrition Examination Survey (Ⅶ-1, 2016). 2016.

3

3. The Korean Society of Hypertension. Guidelines for Hypertension Treatment in 2018. 2018:10-1.

4

4. Ministry of Health & Welfare. Status and development direction of chronic disease management business. Lee JG (Ministry of Health & Welfare Health Policy Officer).

5

5. Ministry of Health and Welfare in Government of the Republic of Korea. National Health Plan 2010. Accessed April 25, 2019. https://www.khealth. or.kr/board?menuId=MENU00725&siteId=null

6

6. Ministry of Health & Welfare Korea Institute for Health and Social Affairs. Comprehensive national health promotion plan(HP2010) Interim Evaluation and Amendment Report, 2006.

7

7. Korea Institute for Health and Social Affairs. Medical Unification Plan’ for shared growth with modern medicine and traditional medicine in Korea. Occasional report. 2013; 21-2.

8

8. Jeong WY. The brief history of Korean traditional medicine (1899-1999). Korean J Med Hist. 1999;8(2):169-255.

9

9. (Republic of Korea) Economic bulletin January 2000 Issue 74-77 Korea Development Institute.

10

10. Korean Medicine Hospitals' Association. Korean Classification of Diseases (한의)Practical application training. HAN CH. 2009.

11

11. Ministry of Government Legislation. Medical assistant law commentary. 1963.08.

12

12. Korea Health Industry Development Institute. Korea Institute of Science & Technology Evaluation and Planning R&D FOCUS. Korean medicine R&D Long-Term Development Plan Study. 2006; 55-63.

13

13. Korea Institute of Science & Technology Evaluation and Planning. Advancement of oriental medicine R & D.

14

14. Lee BH, Kim CH, Seo JC, Youn HM, Jang KJ, Song CH, Ahn CB. The Effects of Decreasement of Blood Pressure on Hypertension Patients by Moxibustion. Journal of Acupuncture Research. 2001;18(5):70-6.

15

15. Han CH, Han CH, Shin MS, Shin SH, Choi SM. The Antihypertensive Effect of Acupuncture Treatment (Gyeok-Pal Sang-Saeng-Yeok-Chim)in Hypertension Patients; Control Study. Journal of Acupuncture Research. 2008;25(6):13-22.

16

16. Lim KT, Hwang EH, Kim BJ, Park IH, Heo I. Chuna Manual Therapy for Essential Hypertension: A Systematic Review. The Journal of Korea CHUNA manual medicine for spine & nerves. 2017;12(1):29-42.

17

17. Cho HJ, Bae DR, Kim HN, Hwang EH. Baduanjin for Hypertension: Systematic Review. The Journal of Korea CHUNA manual medicine for spine & nerves. 2017;12(1):43-56.

18

18. Han IS, Shin JH, Cho YY, Park HM, Yang CS, Jeong MJ, Jang IS, Sun SH. Qu-Ji-Du -Huang-Wan for Essential Hypertension:Systemic Review and Meta-analysis. Korean Journal of Oriental Physiology & Pathology. 2017;31(2):118-25.

19

19. Lee HY, Kang KW, Lee E, Lee SH, Han CH, Jang IS. A Systematic Review on Antihypertensive Effects of Oryeong-san. The Journal of Korean Oriental Internal Medicine. 2013;34(3):289-97.

20

20. Kang KW, Kang JY, Jeong MJ, Kim HJ, Sun SH, Jang IS. The Effect of Cheonmagudeung-eum for Hypertension: A Systematic Review and Meta-analysis. The Journal of Korean Oriental Internal Medicine. 2018;39(1):22-43.

21

21. Abdi H, Tayefi M, Moallem SR, Zhao B, Fayaz M, Ardabili HM, Razavi A, Darbandi M, Darbandi S, Abbasi P, Ferns GA, Majid G. Abdominal and auricular acupuncture reduces blood pressure in hypertensive patients. Complement Ther Med. 2017; 31:20-6.

22

22. Cheng L, Li P, Tjen-A-Looi SC, Longhurst JC. What do we understand from clinical and mechanistic studies on acupuncture treatment for hypertension?. Chinese Medicine. 2015;10(1):36.

23

23. Chen H, Shen FE, Tan XD, Jiang WB, Gu YH. Efficacy and Safety of Acupuncture for Essential Hypertension: A Meta-Analysis. Medical Science Monitor. 2018;24:2946-69.

24

24. Zhao XF, Hu HT, Li JS, Shang HC, Zheng HZ, Niu JF, Shi XM, Wang S. Is Acupuncture Effective for Hypertension? A Systematic Review and Meta-Analysis. PLOS ONE. 2015;10(7):127019.

25

25. Ministry of Health & Welfare. Study on the introduction of Korean Traditional Medicine Management System. 2012.

26

26. National Health Insurance Service. National Health Insurance Sharing Service Sample research DB. Wonju, Korea. Accessed October 29, 2018. https://nhiss.nhis.or.kr/bd/ab/bdaba002cv.do

27

27. Kim JH, Park EC, Kim TH, Lee YH. Hospital Charges and Continuity of Care for Outpatients with Hypertension in South Korea:A Nationwide Population-Based Cohort Study from 2002 to 2013. Korean J Fam Med. 2017;38(5):242–8.

28

28. Lee CJ, Ryu JI, Kim HC, Ryu, DR, Ihm SH, Kim YJ, Shin JH, Pyun WB, Kang HS, Park JH, Hwang JS, Park SH. Clinical Benefit of Treatment of Stage-1, Low-Risk Hypertension:Korean Nationl Health Insurance Daabase Analysis. HYPERTENSION. 2018;72(6):1285–93.

29

29. Commissioner of Statistics Korea (KOSTAT). Korean Standard Classification of Diseases, 7th edition. Accessed October 15, 2018. https://kssc.kostat.go.kr:8443/ksscNew_web/ind ex.jsp#

30

30. Austin PC, Grootendorst P, Anderson GM. A comparison of the ability of different propensity score models to balance measured variables between treated and untreated subjects: a Monte Carlo study. Statistic in Medicine. 2007;26(4):734-53.

31

31. Quan H. Sundararajan V, Halfon P, Fong A, Burnand B, Luthi JC, Saunders LD, Beck CA, Feasby TE, Ghali WA. Coding Algorithms for Defining Comorbidities in ICD-9-CM and ICD-10 Administrative Data. Medical Care. 2005;43(11):1130-9.

32

32. Lee HW, Jung MS, Lee KN. A Study on the Patient's Attitude of Korean Medicine by Social Classes. Journal of Society of Preventive Korean Medicine. 2007;11(2):71-86.

33

33. D'Hoore W, Sicotte C, Tilquin C. Risk adjustment in outcome assessment: The Charlson comorbidity index. Methods of Information in Medicine. 1993;32(5):382-7.

34

34. Haviland A, Nagin DS, Rosenbaum PR. Combining propensity score matching and group-based trajectory analysis in an observational study. PSYCHOLOGICAL METHODS. 2007;12(3):247-314.

35

35. Austin PC. The use of propensity score methods with survival or time-to-event outcomes: reporting measures of effect similar to those used in randomized experiments. Statistics in Medicine. 2014;33(7):1242-58.

36

36. Lee DK. An introduction to propensity score matching methods. Anesthesia and Pain Medicine. 2016;11(2): 130-48.

37

37. Heinze G1, Jüni P. An overview of the objectives of and the approaches to propensity score analyses. European Heart Journal. 2011;32(14):1704-8.

38

38. Leem JT. Does acupuncture reduce the risk of acute myocardial infarction?. Integrative medicine research: IMR. 2016;5(2):165-8.

39

39. Longhurst J. Acupuncture's Cardiovascular Actions: A Mechanistic Perspective. Med Acupunct. 2013 Apr;25(2):101-13.

40

40. Shao M, Li Y, Cui H, Jiang M, Tan Q. Protective effect of acupuncture preconditioning on oxidative stress injury induced by myocardial ischemia-reperfusion injury in rats. Zhongguo Zhen Jiu. 2017 Mar 12;37(3):285-90.

41

41. Fu SP, He SY, Xu B, Hu CJ, Lu SF, Shen WX et al. Acupuncture promotes angiogenesis after myocardial ischemia through H3K9acetylation regulation at VEGF gene. PLoS One. 2014;9(4):e94604.

42

42. Shiflett SC. Does acupuncture work for stroke rehabilitation: what do recent clinical trials really show? Top Stroke Rehabil. 2007;14(4):40-58.

43

43. Shih CC, Liao CC, Sun MF, Su YC, Wen CP, Morisky DE, Sung FC, Hsu CY, Lin JG. A Retrospective Cohort Study Comparing Stroke Recurrence Rate in Ischemic Stroke Patients with and Without Acupuncture Treatment. MEDICINE. 2015;94(39):1572.

44

44. Shih CC, Yeh CC, Hu CJ, Lane HL, Tsai CC, Chen TL, Liao CC. Risk of dementia in patients with non-haemorrhagic stroke receiving acupuncture treatment: a nationwide matched cohort study from Taiwan's National Health Insurance Research Database. BMJ Open. 2017;7(6):013638.

45

45. Weng SW, Liao CC, Yeh CC, Chen TL, Lane HL, Lin JG, Shih CC. Risk of epilepsy in stroke patients receiving acupuncture treatment:a nationwide retrospective matched-cohort study. BMJ Open. 2016;6(7):010539.

46

46. Chang CC, Chen TL, Lin CS, Chung CL, Yeh CC, Hu CJ, Lane HL, Liao CC, Shih CC. Decreased risk of pneumonia in stroke patients receiving acupuncture: A nationwide matched-pair retrospective cohort study. PLOS ONE. 2018;13(5):0196094.

47

47. Fang XM, Chen RL, Tang YP, Wang Q, Fang X, Gu GL, Hang SY, Chen SR, Lee CU. Controlled Clinical Research on the Treatment of Hypertension by Tianmagouteng Decoction in Combination with Western Medicine. Guangxi Zhongyiyao Daxue Xuebao. 2014;17(4):1-4.

48

48. Zhong LQ. Refractory hypertension randomized controlled study Xuefuzhuyu Tang combined western medicine. Journal of practical traditional Chinese internal medicine 2015:29(8):127–8.

49

49. Choi MK, Lee JH, Lee TR, Rhee HS, Rhim KH. The Recognition and Attitude of Users Using the Combined Western-Oriental Medical Institutions. Journal of the Korean Society of Health Information and Health Statistics. 2005;30(1):35-44.

50

50. Park YS, Kim JS. Analysis of the current status outpatient utilization of medical and Korean traditional medical institutions: focuse on outpatient frequent outpatient diseases. Korean Medical Association. 2017;60(11):912–919.

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