National and Regional Trends in the Prevalence of Hypertensionin South Korea Amid the Pandemic, 2009-2022:Nationwide Studyof Over 3 Million Individuals

Background: Understanding the association between hypertension prevalence and socioeconomic and behavioral variablesduring a pandemic is essential, and this analysis should extend beyond short-term trends.Objective: This study aims to examine long-term trends in the prevalence of participants diagnosed with and receiving treatmentfor hypertension, using data collected by a nationally representative survey from 2009 to 2022, which includes the COVID-19pandemic eraMethods: A nationwide, population-based, cross-sectional study used data collected from the South Korea Community HealthSurvey between 2009 and 2022. The study sample comprised 3,208,710 Korean adults over a period of 14 years. We aimed toassess trends in the prevalence of participants diagnosed with and receiving treatment for hypertension in the national populationfrom 2009 to 2022, with a specific focus on the COVID-19 pandemic, using weighted linear regression models.Results: Among the included 3,072,546 Korean adults, 794,239 (25.85%) were aged 19-39 years, 1,179,388 (38.38%) wereaged 40-59 years; 948,097 (30.86%) were aged 60-79 years, and 150,822 (4.91%) were aged 80 years or older. A total of 1,426,379(46.42%) were men; 761,896 (24.80%) and 712,264 (23.18%) were diagnosed with and received treatment for hypertension,respectively. Although the overall prevalence over the 14-year period increased, the upward trends of patients diagnosed withand receiving treatment for hypertension decreased during the COVID-19 pandemic era compared with the prepandemic era (beta difference for trend during vs before the pandemic -.101, 95% CI -0.107 to -0.094 vs -.133, 95% CI -0.140 to -0.127). Notably,the trends in prevalence during the pandemic were less pronounced in subgroups of older adults (>= 60 years old) and individualswith higher alcohol consumption (>= 5 days/month).Conclusions: This nationwide representative study found that the national prevalence of participants diagnosed with andreceiving treatment for hypertension increased during the prepandemic era. However, there was a marked decrease in these trendsduring the prepandemic era, compared with the pandemic era, particularly among specific subgroups at increased risk of negativeoutcomes. Future studies are needed to evaluate the factors associated with changes in the prevalence of hypertension during theCOVID-19 pandemic