Data source and study population. This study was approved by the Institutional Review Board of Gwangju Institute of Science and Technology (20190902-EX-02-02) and was performed based on the Declaration of Helsinki. Since the NHIS-Heals data was provided anonymously according to strict confidentiality guidelines, this study was exempted from receiving the subject's informed consent by Institutional Review Board of Gwangju Institute of Science and Technology. The NHIS database is registered with 98% of Koreans and includes all insurance claims. We analyzed the data using the health screening cohort, which was extracted from a random sampling of approximately 10% of a total 5 million people over 40 years received a health screening in 2002 or 2003. The NHIS provided a mandatory biennial general health screening for people over 40 years. The NHIS-HealS database includes demographic factors (sex, age, and income), hospital utilization (information about the use of medical facilities, admission date, and discharge date), and biennial health screening (height, weight, blood pressure, and blood tests). More information about the database can be found on the relevant website 13. The NHIS-HealS database has been used in many epidemiological studies and its validity is demonstrated elsewhere 14. This study was conducted with adults (age ≥ 40 years) who visited the health screening in 2006 or 2007 (index year) and had at least 3 health screenings from 2002 to 2007. Subjects meeting the criteria for the diagnosis of hypertension before the index year were excluded. Subjects with one or more missing values were also excluded.