South Korea, renowned for its high consumption of salty foods like ramen and kimchi, has emerged as a global model for hypertension management. The prestigious medical journal The Lancet recently highlighted South Korea’s success story in controlling high blood pressure, attributing it to several factors including the widespread adoption of kimchi refrigerators, a comprehensive national health insurance system, affordable medication, and a robust patient management system.
According to medical experts on Thursday, The Lancet’s June 6 publication, Hypertension control: a South Korean success story, praised South Korea as one of the few nations worldwide to successfully manage hypertension at a population level. The Lancet, widely regarded as one of the most influential academic journals, consistently ranks among the top one or two in terms of citation impact.
While approximately 1.7 billion people globally suffer from hypertension, less than 20% effectively control their blood pressure. The Lancet emphasized that hypertension is a primary risk factor for cardiovascular diseases and a leading cause of heart attacks, strokes, chronic kidney disease, and dementia.
In contrast, South Korea has made remarkable progress in hypertension management over the past 15 years through collaborative efforts between the government and healthcare sector. Tom Frieden, Chief Executive Officer (CEO) of the nonprofit organization Resolve to Save Lives, told The Lancet that South Korea’s success in managing hypertension could serve as a global model, showcasing the effectiveness of evidence-based intervention policies.
The Lancet particularly highlighted South Korea’s sodium reduction initiatives. Since 2012, the South Korean government has implemented a national plan aimed at reducing sodium intake by 20%, working closely with the food industry to lower salt content in processed foods.
In this context, kimchi refrigerators have played a pivotal role. The Lancet noted that the introduction of these specialized appliances eliminated the need for excessive salt in long-term kimchi preservation, contributing significantly to reduced sodium consumption among Koreans. In fact, adult sodium intake dropped by an impressive 23.7% just two years after the policy’s implementation.
The national health insurance system and the management framework of the Health Insurance Review and Assessment Service (HIRA) were also identified as key success factors. The Lancet explained that following the separation of prescribing and dispensing medications, patients began receiving consistent care and prescriptions from doctors. Meanwhile, HIRA tracked screening, medication, and follow-up visits, imposing penalties on underperforming institutions to improve blood pressure control levels.
Regular health check-ups have also played a crucial role. Professor Kim Hyun-chang from Yonsei University’s Department of Preventive Medicine told The Lancet that with participation rates in national health screenings reaching 70-80%, they’ve significantly increased opportunities for early detection of undiagnosed hypertension cases.
Affordable medication was identified as another advantage. The Lancet noted that effective blood pressure medications, such as calcium channel blockers (CCBs) and angiotensin receptor blockers (ARBs), are prescribed with low out-of-pocket costs. Moreover, the rate of combination drug prescriptions in South Korea is among the highest globally.
Consequently, South Korea’s blood pressure control rate has risen to approximately 62%. The Lancet drew a stark comparison with Thailand, where the blood pressure control rate, once similar to South Korea’s two decades ago, now stagnates at 23%. This disparity was attributed to differences in policy priorities and institutional commitment rather than healthcare infrastructure.
However, challenges persist. The Lancet pointed out that South Koreans still consume about twice the recommended levels of sodium. Additionally, factors such as increasingly Westernized diets, rising obesity rates, and an aging population have limited the reduction in hypertension prevalence.
Kim Kwang-il, president of the Korean Society of Hypertension, emphasized that the most crucial starting point for improving hypertension management is fostering collaboration between the government, academic societies, and primary care physicians to discuss issues and develop effective strategies.