• Journal of Korean Academy of Nursing
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• v.45 no.6
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• pp.857-867
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• 2015

Purpose: The purpose of this study was to investigate individual and organizational level of cardiovascular disease (CVD) risk factors associated with CVD risk in Korean blue-collar workers working in small sized companies. Methods: Self-report questionnaires and blood sampling for lipid and glucose were collected from 492 workers in 31 small sized companies in Korea. Multilevel modeling was conducted to estimate effects of related factors at the individual and organizational level. Results: Multilevel regression analysis showed that workers in the workplace having a cafeteria had 1.81 times higher CVD risk after adjusting for factors at the individual level (p =.022). The explanatory power of variables related to organizational level variances in CVD risk was 17.1%. Conclusion: The results of this study indicate that differences in the CVD risk were related to organizational factors. It is necessary to consider not only individual factors but also organizational factors when planning a CVD risk reduction program. The factors caused by having cafeteria in the workplace can be reduced by improvement in the CVD-related risk environment, therefore an organizational-level intervention approach should be available to reduce CVD risk of workers in small sized companies in Korea.

• Journal of Korean Academy of Nursing
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• v.42 no.7
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• pp.1095-1104
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• 2012

Purpose: The purpose of this study was to investigate the contribution of actual cardiovascular disease (CVD) risk, as well as, individual, psychosocial, and work-related factors as predictors of CVD risk perception among Korean blue-collar workers. Methods: The participants were 238 Korean blue-collar workers who worked in small companies. Data were collected through a survey; anthropometric and blood pressure measures; and blood sampling for lipid levels. Results: Blue-collar workers had high actual CVD risk and low CVD risk perception. The significant predictors of risk perception included perceived health status, alcohol consumption, knowledge of CVD risk, actual CVD risk, decision latitude, and shift work. The model explained 26% of the variance in CVD risk perception. Conclusion: The result suggests when occupational health nurses are giving routine health examination in small companies, they can enhance CVD risk perception in blue-collar workers by providing essential information about CVD risk factors and personal counseling on the individual worker's CVD risk status.

• Journal of Preventive Medicine and Public Health
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• v.31 no.1 s.60
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• pp.27-48
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• 1998

This study was conducted to integrate the results of studies which evaluated or identified the risk factors of CVD(cerebrovascular disorders) for Koreans. We retrieved the literature published in Korean by manual search and the English literature by Medline database to identify studies on the relationship between reported risk factors and CVD conducted for the Korean from 1980 to August, 1997. Hypertension and total serum cholesterol were selected as subjects of quantitative meta-analysis on risk factors of CVD in Koreans. The overall effect sizes of the risk of CVD due to hypertension and total serum cholesterol were calculated by common odds ratio(OR) and average standardized mean difference, retrospectively. Before the integration of each effect sizes into common effect sizes, the heterogeneity tests were conducted. Also, sensitivity tests were conducted for the estimated common effect sizes. Regarding hypertension and CVD, a total of 9 epidemiologic studies were identified with a total of 2,271 cases of CVD. The overall OR of hypertension associated CVD was 4.10(95% confidence interval[CI] 3.56 to 4.71). The OR of hypertension associated with hemorrhagic CVD and ischemic CVD were 6.56(95% CI : 4.92 to 8.80) and 3.28 (95% CI : 2.77 to 3.90), retrospectively. The OR of hypertension in relation to hemorrhagic CVD was significantly higher than that of hypertension in relation to overall CVD or ischemic CVD. Regarding total serum cholesterol and ischemic CVD, total 9 epidemiologic studies were identified with a total of 843 cases of ischemic CVD. Average mean difference as an effect size was 0.76, which was judged an important value according to Cohen's criteria. Our data suggested that hypertension was an important risk factor of overall CVD and its subtypes, and that the total serum cholesterol was associated with ischemic CVD in Koreans. For the lack of reliable prospective studies, however, we concluded that further research designed longitudinally would be required in this area.

• Journal of the Ergonomics Society of Korea
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• v.33 no.4
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• pp.289-297
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• 2014

Objective: The purpose of this study is to identify the incidence risk of cardiovascular disease (CVD) in the workplace, and to suggest the prediction models for level of CVD incidence risk. Background: CVD can be caused by various factors related to personal habits such as diet and exercise, or genetics. However it can also be caused and aggravated by work, making the elimination of such risk factors at work crucial disease (KOSHA, 2013). Method: The distribution of CVD risk assessment levels of 162 workers was compared with the acquired medical examination data to discuss the necessity of assigning additional risk factors. Two alternative risk assessment models were given to enhance the accuracy of the evaluation; adjusting risk scores given in the KOSHA GUIDE H-1-2013 (alternative 1) and building a matrix of KOSHA GUIDE H-1-2013 and risk assessment results based on work condition levels (alternative 2). To verify the suggested models, medical examination results of 12 workers approved of convalescence were referred to. Results: The second alternative showed more relevance between the results and workers approved of convalescence in predicting the risk group when applied to actual heath examination data from the approved workers. The power of description of the new method for determining the risk of CVD incidence, 83.3%, is higher than that of KOSHA GUIDE H-1-2013, 25%. Conclusion: Results of this study imply that more approved workers had been from unmanaged normal groups than managed risk groups, raising the importance of CVD management. Application: The new prediction model considering working time and shift work developed in this study is expected to be a fundamental data for risk analysis and management of CVD in the workplace.

• Korean Circulation Journal
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• v.53 no.1
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• pp.17-30
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• 2023

Background and Objectives: To evaluate the impact of smoking in young adults on the risk of cardiovascular disease (CVD) and the clustering effect of behavioral risk factors such as smoking, obesity, and depression. Methods: A Korean nationwide population-based cohort of a total of 3,280,826 participants aged 20-39 years old who underwent 2 consecutive health examinations were included. They were followed up until the date of CVD (myocardial infarction [MI] or stroke), or December 2018 (median, 6 years). Results: Current smoking, early age of smoking initiation, and smoking intensity were associated with an increased risk of CVD incidence. Even after quitting smoking, the risk of MI was still high in quitters compared with non-smokers. Cigarette smoking, obesity, and depression were independently associated with a 1.3-1.7 times increased risk of CVD, and clustering of 2 or more of these behavioral risk factors was associated with a 2-3 times increased risk of CVD in young adults. Conclusions: In young adults, cigarette smoking was associated with the risk of CVD, and the clustering of 2 or more behavioral risk factors showed an additive risk of CVD.

• Korean Journal of Community Nutrition
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• v.3 no.5
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• pp.685-694
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• 1998

This cross-sectional study was conducted to describe the changes of plasma cardiovascular disease(CVD) risk factors in Korea. Overnight fasting plasma levels of total cholesterol, high density lipoprotein(HDL)-cholesterol, triacylglycerol and glucose were analyzed. Blood pressure and anthropometric data were also measured. Health practice factors such as smoking status, alcohol consumption and frequency fo exercise were evaluated by a self-administered questionnaire. Questions regarding dietary habits and food preferences were also asked. Seventy eight percent of the subjects had more than one CVD risk factor. Plasma total cholesterol, triacylglycerol, and fasting blood glucose were significantly increased according to the subjects body mass index$(kg/m^2$, BMI), whereas HDL-cholesterol, low density lipoprotein(LDL)-cholesterol and blood pressure showed no significant differences with BMI. Current smokers had significantly high plasma total cholesterol, LDL-cholesterol and triacylglycerol levels. Alcohol consumption significantly increased plasma total cholesterol and fasting blood sugar, but regular exercise had no effects on the plasma CVD risk factors. Overeating and frequency of fast food consumption were positively correlated with the CVD risk score, whereas intake of grains, meats and vegetables were negatively correlated with that score. A stepwise multiple regression analysis was performed to examine the effects of specific dietary factors on plasma lipid levels. For plasma total cholesterol level, the frequency of fast food intake explained 8% of the variance, followed by habitual overeating, frequency of grain intake and high cholesterol food intake(Model $R^2$=22.4%). For plasma triacylglycerol level, preference of oily foods accounted for 7.5% of the variance, followed by eating breakfast, preference of fruit and frequency of grain intake(Model $R^2$=22.0%). The findings suggest that intervention programs to reduce the risk of CVD should focus on health practice through reducing BMI, smoking cessation and moderate or no alcohol drinking. Moreover, desirable dietary habits such as eating breakfast, not overeating and reduced intake of fast food may improve CVD risk.

• Korean Journal of Occupational Health Nursing
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• v.25 no.1
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• pp.41-54
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• 2016

Purpose: The purposes of this study were to review the research trends and to identify developmental direction of studies on community interventions according to the ecological model for workers with cardiovascular diseases (CVD) risk factors. Methods: Electronic databases including PsycINFO, PubMed, EMBASE, CINAHL, and Cochrane Library and the reference lists of articles were searched. All articles were assessed in relation to inclusion and exclusion criteria, resulting in 29 researches being reviewed. Each review was critically appraised by two authors using a guideline of PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses). Results: Nowadays, interventions in organizational level, integrated and web-based interventions are increasing to prevent CVD risk factors for workers. Even though the importance of psychosocial aspects to prevent CVD, the only 2 studies included psychosocial factors in the outcome variables. Also, 14% among 29 researches were based on theories. Conclusion: Psychosocial factors such as job stress, depression, and emotional labor could be CVD risk factors. Therefore, interventions including psychosocial aspects are needed to prevent workers' CVD risks more effectively. Theory-based interventions are needed to support interventions' effects and to develop the nursing science.

• Journal of Preventive Medicine and Public Health
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• v.34 no.2
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• pp.157-165
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• 2001

Objectives : To identify the risk factors of cerebrovascular disorders(CVD) in Koreans using a nested case-control study. Methods : The cohort consisted of beneficiaries who had taken health examinations of the Korea Medical Insurance Corporation (KMIC cohort: 115,600 persons) in 1990 and 1992 consecutively. Four hundred and twenty five (425) cases were selected following the validation of diagnosis among 2,026 reported CVD (160-168) inpatients during the year from 1993 to 1997. Controls were matched (1:1) with age and gender of the cases among inpatients without CVD during the same period. The source of data in this study were the files of the 1990 health examinations and the 1992 health questionnaires, as well as an additional telephone survey undertaken from March to November 1999. Results : In a bivariate analysis and multiple logistic regression analysis, risk factors for total CVD were hyperglycemia and hypertension. Unrespectively, the odds ratio of ex-smoker was significantly lower than that of those who had never smoked. The risk factors for ischemic CVD also were hyperglycemia and hypertension. However, only blood pressure was found to be a risk factor for hemorrhagic CVD. Hypercholesterolemia was not a risk factor for total CVD, ischemic CVD, and hemorrhagic CVD. Conclusion : We concluded that the most important risk factor for CVD (including subtype) in Koreans was hypertension.

• Annals of Occupational and Environmental Medicine
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• v.35
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• pp.35.1-35.11
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• 2023

Background: Cardio-cerebrovascular diseases (CVDs) are the most common cause of death worldwide. Various CVD risk assessment tools have been developed. In South Korea, the Korea Occupational Safety & Health Agency (KOSHA) and the National Health Insurance Service (NHIS) have provided CVD risk assessments with health checkups. Since 2018, the KOSHA guide has stated that NHIS CVD risk assessment tool could be used as an alternative of KOSHA assessment tool for evaluating CVD risk of workers. The objective of this study was to determine the correlation and agreement between the KOSHA and the NHIS CVD risk assessment tools. Methods: Subjects of this study were 17,485 examinees aged 20 to 64 years who had undergone medical examinations from January 2021 to December 2021 at a general hospital. We classified subjects into low-risk, moderate-risk, high-risk, and highest-risk groups according to KOSHA and NHIS's CVD risk assessment tools. We then compared them with cross-analysis, Spearman correlation analysis, and linearly weighted kappa coefficient. Results: The correlation between KOSHA and NHIS tools was statistically significant (p-value < 0.001), with a correlation coefficient of 0.403 and a kappa coefficient of 0.203. When we compared risk group distribution using KOSHA and NHIS tools, CVD risk of 6,498 (37.1%) participants showed a concordance. Compared to the NHIS tool, the KOSHA tool classified 9,908 (56.7%) participants into a lower risk category and 1,079 (6.2%) participants into a higher risk category. Conclusions: In this study, KOSHA and NHIS tools showed a moderate correlation with a fair agreement. The NHIS tool showed a tendency to classify participants to higher CVD risk group than the KOSHA tool. To prevent CVD more effectively, a higher estimation tool among verified CVD risk assessment methods should be selected and managements such as early intervention and treatment of risk factors should be performed targeting the high-risk group.

• Journal of Preventive Medicine and Public Health
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• v.47 no.4
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• pp.216-229
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• 2014

Objectives: This study aims to investigate trends of cardiovascular disease (CVD) risk factor profiles over 17 years in percutaneous coronary intervention (PCI) patients at the Mayo Clinic. Methods: We performed a time-trend analysis within the Mayo Clinic PCI Registry from 1994 to 2010. Results were the incidence and prevalence of CVD risk factors as estimate by the Framingham risk score. Results: Between 1994 and 2010, 25 519 patients underwent a PCI. During the time assessed, the mean age at PCI became older, but the gender distribution did not change. A significant trend towards higher body mass index and more prevalent hypercholesterolemia, hypertension, and diabetes was found over time. The prevalence of current smokers remained unchanged. The prevalence of ever-smokers decreased among males, but increased among females. However, overall CVD risk according to the Framingham risk score (FRS) and 10-year CVD risk significantly decreased. The use of most of medications elevated from 1994 to 2010, except for ${\beta}$-blockers and angiotensin converting enzyme inhibitors decreased after 2007 and 2006 in both baseline and discharge, respectively. Conclusions: Most of the major risk factors improved and the FRS and 10-year CVD risk declined in this population of PCI patients. However, obesity, history of hypercholesterolemia, hypertension, diabetes, and medication use increased substantially. Improvements to blood pressure and lipid profile management because of medication use may have influenced the positive trends.