• Journal of Preventive Medicine and Public Health
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• 제57권3호
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• pp.260-268
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• 2024

Objectives: Regional disparities in cardiovascular care in Korea have led to uneven patient outcomes. Despite the growing need for and access to procedures, few studies have linked regional service availability to mortality rates. This study analyzed regional variation in the utilization of major cardiovascular procedures and their associations with short-term mortality to provide better evidence regarding the relationship between healthcare resource distribution and patient survival. Methods: A cross-sectional study was conducted using nationwide claims data for patients who underwent coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), stent insertion, or aortic aneurysm resection in 2022. Regional variation was assessed by the relevance index (RI). The associations between the regional RI and 30-day mortality were analyzed. Results: The RI was lowest for aortic aneurysm resection (mean, 26.2; standard deviation, 26.1), indicating the most uneven regional distribution among the surgical procedures. Patients undergoing this procedure in regions with higher RIs showed significantly lower 30-day mortality (adjusted odds ratio [aOR], 0.73; 95% confidence interval, 0.55 to 0.96; p=0.026) versus those with lower RIs. This suggests that cardiovascular surgery regional availability, as measured by RI, has an impact on mortality rates for certain complex surgical procedures. The RI was not associated with significant mortality differences for more widely available procedures like CABG (aOR, 0.96), PCI (aOR, 1.00), or stent insertion (aOR, 0.91). Conclusions: Significant regional variation and underutilization of cardiovascular surgery were found, with reduced access linked to worse mortality for complex procedures. Disparities should be addressed through collaboration among hospitals and policy efforts to improve outcomes.

• Journal of Nutrition and Health
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• 제38권6호
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• pp.445-454
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• 2005

The purpose of this study was to compare the validity of obese index among body mass index (BMI), waist to hip ratio (WHR), and waist circumference (WC) and to determine which is the best in relation to cardiovascular disease (CVD) risk in Korean elderly more than 65 ages. Data from the 1998 Korean Health and Nutrition Survey were used (n=1017). Anthropometric indices and CVD risk factors were measured, and chi-square test, analysis of variance following duncan's multiple range test, partial correlation analysis, and Receiver Operator Characteristic (ROC) curves were used in the analysis. Anthropometric values were decreased in both male and female when ages were goes up. In female elderly, it specially showed the characteristics of upper body fat and systolic blood pressure risk (p<0.05). Among life style factors the current smokers were prevalent in obese male (p<0.05), but not prevalent in female having obese or upper body fat. Also, person with upper body obesity have more exercise than that of normal group (p<0.01). Mean BMI values of the current smoker was lower than that of normal group in both sexes (p<0.01). Mean BMI value of person with other risk factors were higher than that of normal groups (p<0.05). Among 7 CVD risk factors in partial correlation analysis, WC had the highest correlation coefficient in 5 in male, whereas BMI in 4 in female. In ROC analyses of 12 risk factors and health conditions, the largest area under curve of obese indices for risk factors were WC>WHR>BMI in male and BMI>WHR>WC in female. The optimal cutoff values of each index (BMI : WHR : WC) for one or more risk factors were 19.02 : 0.84 : 71.3 in male and 19.04 : 0.88 : 85.6 in female. In conclusion, Most Korean elderly showed non-obese and abdominal obesity likewise other Asians. Also CVD risk factors were prevalent in Korean elderly within normal limits of obese indices. Therefore the upper body fat indices reflected in the aged whose muscle mass is replaced by fat must be used as an indicator of CVD risk together with BMI. Although WHR was the worst index based on partial correlation analysis and so located between BMI and WC in ROC curve analysis in both sexes, it need to be use with WC to screen the cardiovascular risk group.

• 보건교육건강증진학회지
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• 제20권2호
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• pp.113-125
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• 2003

Background： Recently, adolescent obesity was increased and tended to become obese adults, facing increased risk for diabetes, cardiovascular disease. Even before reaching adulthood, adolescent obesity already was experiencing hypertension, dyslipidemia, and diabetes mellitus. The purpose of this study was to find prevalence of obesity of high school students in Jeju island and association between obesity and cardiovascular risk factors and association between childhood obesity and adolescent obesity. Method： The study subjects were 6,064 students of twenty-two high school in Jeju island and health survey data was gathered from high school health examination data and hospital health examination data from Aug. 1999 to Dec. 1999. Adolescent obesity was evaluated by ideal body weight method in 1998 and body mass index. Cardiovascular risk factors were checked total cholesterol, systolic and diastolic blood pressure, fasting blood sugar. In 1,534 students, obesity at primary school is checked by primary and middle school health record. Results： Prevalence of obesity in Jeju island high school students is 12.6% in male students, 13.3% in female students by ideal body weight method and 8.7% in male students, 8.5% in female students by body mass index. Prevalence of obesity of male students in city area and district area of Jeju island were each 12.9%, 10.3% and that of male students in city area was significantly higher. Prevalence of obesity of female students in city area and district area of Jeju island were each 12.9%, 14.2% and not significantly different. Prevalence of obesity of male students in general and commercial school group were each 13.9%, 10.1% and that of general school group was significantly higher. In female students, Prevalence of obesity general and commercial school group was not significantly different. Total cholesterol, systolic and diastolic blood pressure were significantly associated with degree of obesity in male and female students(p＜0.05) and fasting blood sugar was only significantly associated with degree of obesity in male students(p＜0.05). In 1,514 students checked by health record, Odds ratio of obesity at primary and middle school that at high school were 12.96∼22.77 and was significantly associated. Conclusion： Prevalence of obesity of high school students in Jeju island is very high and adolescent obesity was significantly associated with cardiovascular risk factors. Mostly childhood obesity tended to become adolescent obesity and program of control of obesity at childhood and adolescence is required.

• 대한방사선기술학회지:방사선기술과학
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• 제46권4호
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• pp.303-313
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• 2023

This study aimed to investigate the relevance of cardiovascular disease risk factors AI and AIP, divided into three groups, among 300 individuals who underwent health checkups at the hospital. Various variables such as Age, Sex, BMI, WC, TC, TG, HDL-C, LDL-C, FBS, HbA1C, SBP, DBP, HR, AI (TC/HDL-C), and AIP (log(TG/HDL-C)) were analyzed using statistical methods including frequency analysis, cross-tabulation, one-way ANOVA, Pearson's correlation analysis, and multiple linear regression analysis. The cross-analysis based on cardiovascular disease risk criteria revealed that men and individuals in their 50s had higher cardiovascular disease risk based on AI and AIP. Significant differences were observed in TG, TC, HDL-C, LDL-C, SBP, DBP, AI (TC/HDL-C), and AIP (log(TG/HDL-C)) according to AI criteria. For the AIP criteria, TG, TC, HDL-C, FBS, HbA1C, HR, AI (TC/HDL-C), and AIP (log(TG/HDL-C)) were identified as cardiovascular disease risk factors. FBS and HbA1c showed the highest positive correlation In the correlation analysis, followed by TC and LDL-C. The lowest positive correlation was observed between LDL-C and DBP. In terms of negative correlation, HDL-C and AI had the highest negative correlation, while LDL-C and TG showed the lowest negative correlation. Multiple regression analysis indicated that the AI and AIP risk criteria had explanatory powers of 73.6% and 72.5%, respectively. HDL-C had the greatest negative effect on the AI risk criterion, while TG had the most significant influence on the AIP risk criterion. In conclusion, while other serological variables are important, managing HDL-C and TG levels may help reduce the risk of cardiovascular disease.

• Journal of Preventive Medicine and Public Health
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• 제30권2호
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• pp.327-341
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• 1997

It is a well known fact that obesity is an important cause of cardiovascular disease, emphasized by many studies. Recently, cardiovascular diseaase has been found to correlate not only to the extent of obesity, but also the fat distribution of the individual; especially, focusing on obesity of the abdomen. Unfortunately, the proposed indices for abdominal obesity are numerous, and the results vary according to the index chosen. Three-hundred and twelve bus drivers in November, 1995, were chosen as subjects of this study. The author chose to measure serum lipid levels, fasting blood sugar levels and blood pressure, that are thought to be important risk factors of cardiovascular diseases. Obesity indices were calculated using anthropometric measurements. We were able to evaluate the significance of obesity indices by examining correlations between these indices and the risk factors of cardiovascular disease. The results obtained were as follows: 1. The abdominal obesity indices and risk factors of cardiovascular disease, the levels of total cholesterol in the serum, fasting blood sugar levels, and diastolic blood pressure, increased significantly according to age. 2. There was a significant difference in the abdominal obesity indices according to drinking and smoking habits controlled for age. Among the risk factors of cardiovascular disease, triglyceride and diastolic pressures had significant differences according to the presence or absence of a drinking history controlled for age. 3. Although all obesity indices showed significant correlations, the weakest correlation was between BMI and abdominal diameter index and the strongest correlation was between sagittal diameter and sagittal diameter matched for height. 4. There was a negative correlation between HDL-cholesterol and obesity indices. The weakest correlation was between fasting blood sugar levels and both SD and SDH showed correlations with the risk factors. 5. There was a significant correlation between SD and total cholesterol in the serum and fasting blood sugars controlled for age, drinking, and BMI. 6. After categorizing the subjects into 2 separate age groups at the 40 year mark, in the less than 40 you old age group, controlled for drinking and BMI, the results of comparitive studies have shown correlations between total cholesterol serum levels and waist-hip ratio, conicity-index, and SD. There were correlations between fasting blood sugar levels and SD, ADI, and SDH. There were no correlations between obesity indices and both total cholesterol serum levels and fasting blood sugar levels in the greater than 40 year old age group. There were significant correlations between abdominal obesity indices and total serum cholesterol or fasting blood sugar levels in the less than 40 year old age group, but no correlations in the age group over 40. These correlated factors between abdominal obesity and cardiovascular disease are assumed to exist in Korea as well. Furthermore, in this study a high correlation was found between SD, SDH and the risk factors of cardiovascular disease. Even when controlled for age, drinking, smoking, and BMI, the correlations between risk factors of cardiovascular disease and these indices exist. Therefore, the obesity indices, SD and SDH may prove to be important prognostic indicators or risk factors of cardiovascular disease.

• 여성건강간호학회지
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• 제16권3호
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• pp.224-233
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• 2010

Purpose: This study explored the relationships among obesity, bone mineral density, and cardiovascular risks in post-menopausal women. Methods: One hundred post-menopausal women were recruited via convenience sampling from osteoporosis prevention program participants who were living in a metropolitan city in September 2006. Obesity was evaluated by body mass index, bone mineral density measured by DEXA scan, and cardiovascular risk factors assessed by a guideline of American Heart Association. Results: Seventy-two percent of women were either in the osteopenia or osteoporosis group, while 28% were in normal range in lumbar vertebrae. Obese women had greater bone mineral density in lumbar (F=3.31, p=.040) and femur (F=4.72, p=.011). Variables for cardiovascular risks were significantly different for high density lipoprotein (F=7.51, p=.001), systolic blood pressure (F=5.21, p=.007), and in percent of 10-year cardiovascular disease risk according to obesity. Conclusion: Post-menopausal women are at risk for obesity, osteoporosis, and cardiovascular disease. In order to prevent these conditions, nursing interventions such as resistance and aerobic exercise that reduces body weight and bone loss, increases high density lipoprotein, and reduces systolic blood pressure, should be proposed continually through health promotion programs for postmenopausal women.

• Journal of Preventive Medicine and Public Health
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• 제39권6호
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• pp.462-468
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• 2006

Objectives : The purpose of this study was to gain an understanding of the effects of three exercise types on anthropometric and serum lipids and physiological index factors, which are known to be the three risk factors of cardiovascular disease in male workers. Methods : The experimental study period was 12 weeks. In this study, 30-40's males (N=31) were assigned to 3 experimental groups: regular aerobic(treadmill walking) exercise group, regular anaerobic(muscular endurance) exercise group, irregular aerobic & anaerobic exercise group and a control group using a stratified random assignment method. Results : In relation to anthropometric factors, the regular aerobic & anaerobic exercise groups showed significant decreases in Weight, Broca's index, WC, BMI, WHtR, WHpR and HRrest. With regard to the serum lipid factors, the TC was decreased, but the HDL-c increased among the regular aerobic & anaerobic exercise groups. However, no significant difference was found between the other groups in respect to the LDL-c and TG. Considering the physiological factors, the TC/HD-c, TC-HDL/HDL-c, LDL-C/HDL-c and NON-HDL-c ratios were decreased, but the HDL-c/TC ratio increased among the regular aerobic & anaerobic exercise groups. The TG/HDL-c and HDL-c/LDL-c ratios showed no significant differences between the groups. These results indicated that the positive change for each factor is much larger in the regular exercise groups, especially in the anaerobic exercise group. Conclusions : The results indicate that not only regular aerobic exercise, but also regular anaerobic(muscular endurance) exercise could be utilized in lessening the deleterious effects of the risk index factors for cardiovascular disease.

• Journal of Preventive Medicine and Public Health
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• 제35권3호
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• pp.214-220
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• 2002

Objectives : To investigate the relationship of serum uric acid to cardiovascular risk factors in Korean male workers. Methods : We screened 522 male workers at an electrical manufacturing company by a periodic health examination and a questionnaire survey in 2000. We collected data relating to age, smoking status, alcohol drinking status, body mass index (BMI), blood pressure, serum lipid, fasting blood glucose and serum uric acid. The data were analyzed using a variety of methods, including ANOVA, Pearson's correlation, and multivariate regression analyses. to examine the association between uric acid and cardiovascular risk factors with a cross-sectional study design. Results : The concentration of serum uric acid showed positive associations with BMI, total cholesterol, triglyceride, and LDL-cholesterol; it was also significantly correlated to systolic and diastolic blood pressures. Life-style characteristics, such as smoking and alcohol drinking showed no significant association. From the multivariate regression analyses, BMI, total cholesterol and fasting blood glucose levels were found to be independent positive predictors of uric acid; while age, blood pressure and smoking status give no independent contribution explaining the variability of serum uric acid levels. Conclusions : This study demonstrates that serum uric acid level have a significant association with cardiovascular risk factors, such as BMI, total cholesterol and blood glucose in some Korean male workers.

• Toxicological Research
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• 제28권4호
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• pp.269-277
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• 2012

The purpose of this study was to understand the mechanism of cardiovascular disease (CVD) caused by exposure to hazardous chemicals. We investigated changes in the symptoms of metabolic syndrome, which is strongly related to CVD, and in levels of other CVD risk factors, with a special emphasis on the roles of catecholamines and oxidative stress. The results revealed that neither body mass index (BMI) nor waist and hip circumferences were associated with exposure to hazardous chemicals. Among metabolic syndrome criteria, only HDL-cholesterol level increased on exposure to hazardous chemicals. Levels of epinephrine (EP) and norepinephrine (NEP) were not influenced by exposure to hazardous chemicals; however, the total antioxidative capacity (TAC) reduced because of increased oxidative stress. Both hazardous chemical exposure level and metabolite excretion were related to EP, NEP, and the oxidative stress index (OSI). Logistic regression analysis with these factors as independent variables and metabolic syndrome criteria as dependent variables revealed that EP was associated with blood pressure, and NEP with metabolic syndrome in the chemical-exposed group. In conclusion, the results suggest that reactive oxygen species generated and oxidative stress due to exposure to hazardous chemicals act as mediators and cause changes in the physiological levels of EP and NEP to increase blood pressure. This ultimately leads to the development of CVD through increase in cholesterol, triglyceride, and blood glucose levels by lipid peroxidation.

• 한국산업보건학회지
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• 제31권4호
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• pp.367-377
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• 2021

Objectives: Taxi drivers are exposed to various hazards, such as long periods of sedentary work and traffic-related air pollutants. However, studies on the health effects among taxi drivers in South Korea are insufficient. Methods: To assess subclinical hematologic change related to cardiovascular disease among male taxi drivers, we analyzed data from the second Korean National Environmental Health Survey. Fifty-nine taxi drivers and 1,912 controls were included in the analysis. Propensity score matching was performed to adjust for age, body mass index, and urinary cotinine. A total of 295 subjects were matched with 59 taxi drivers. Leukocyte count, platelet count, hematocrit, triglyceride, total cholesterol, HDL cholesterol land total IgE of the taxi drivers were compared with the control groups. Results: Taxi drivers showed significantly elevated blood leukocytes and platelets. Serum total IgE was significantly reduced in taxi drivers. However, blood leukocytes, platelets, and serum total IgE were not significantly correlated with work period among taxi drivers. Conclusions: Regarding the change of the blood leukocyte count, platelet count, and serum total IgE, taxi driving has the possibility to be associated with peripheral inflammation, humoral immunity and cardiovascular risk.