Temporal Trends in Lifestyle Modification of Patients with Hypertension in Korea, 1998–2021

Background Lifestyle modification is crucial in managing hypertension, independent of medical treatment. This study aimed to evaluate the implementation of lifestyle modifications and analyze the trends in lifestyle modification among patients with hypertension in Korea over the past two decades. Methods We analyzed data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted between 1998 and 2021. The study included adults aged ≥ 20 years. Factors such as regular physical activity, smoking and alcohol abstinence, weight and stress management, and adherence to a healthy diet were analyzed. Results A significant threefold increase was observed in the proportion of patients with hypertension who adhered to sodium restriction compared with 20 years ago. However, 70% of patients with hypertension consume more sodium than recommended. Moreover, potassium intake has steadily decreased since 2014, with only 23.8% of patients with hypertension meeting the recommended intake. The body mass index (BMI) and waist circumference of patients with hypertension have gradually increased, with fewer patients maintaining an appropriate weight. The neglect of diet and weight control among young patients with hypertension who experience high stress levels poses challenges in modifying their lifestyles. Conclusions Patients with hypertension in Korea still consume high amounts of sodium, whereas potassium intake is gradually decreasing. Additionally, obesity rates have been increasing, especially among young patients with hypertension. Considering the increasing number of young patients with hypertension and the low control rate, the importance of lifestyle modifications should be further emphasized. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This research was supported by the 2021 Chung-Ang University research grant. The content is solely the responsibility of the authors and does not necessarily represent the official view of any funding agency. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Institutional Review Board of the Chung-Ang University Gwangmyeong Hospital approved the study protocol, which complied with the principles of the Declaration of Helsinki. The requirement for informed consent was waived because of the retrospective nature of the study. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data from the Korea National Health and Nutrition Examination Survey (KNHANES). KNHANES is a nationwide representative cross-sectional survey conducted by the Korea Centers for Disease Control and Prevention. * KNHANES : Korea National Health and Nutrition Examination Survey BMI : body mass index BP : blood pressure SBP : systolic blood pressure DBP : diastolic blood pressure DM : diabetes mellitus HbA1c : glycated hemoglobin DASH : Dietary Approaches to Stop Hypertension