• 대한간호학회지
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• 제29권6호
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• pp.1192-1207
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• 1999

The purpose of this study was to clarify the dynamic relationships among risk factors of arteriosclerosis and to develop and examine a model which could explain this relationship clearly. Data were collected from medical records of 400 male clients who visited a university hospital located in Inchon for physical examinations, from May 1996 to December 1996. Data were analyzed using the LISREL (Linear Structural Relationship) 8 program. To test the fitness of the hypothesized model, chi-square, RMSR (root mean square residual), GFI (goodness of fit index), CN (critical number) and Q-plot were used. Most of the fitness measurements, except the chi-square showed that the hypothesized model complimented the real data. According to the results, there were trends that obesity and hyperlipidemia were prevalent in heavier smokers, higher alcohol intakers, and groups who excercised less. Also, hypertension was more prevalent in older age, higher alcohol intaker, and higher serum lipid level groups. In contrast to the hypothesis, alcohol intake did not significantly affect serum lipid levels. This might be due to the serum lipid measurements (total cholesterol and trigryceride) used in this study to estimate hyperlipidemia. The direct effect of smoking on hypertension was not significant. However, the total effect of smoking on the hypertension was significant since indirect effects of smoking on hypertension, such as obesity and hyperlipidemia, were significant. The total effect of obesity on hypertension was significant since the indirect effect of obesity on hypertension via hyperlipidemia was significant, although the direct effect of smoking on hypertension was not significant. The degree of explaining hyperlipidemia with smoking, exercise, and obesity was high (60%), however, the degree of explaining obesity with age, smoking, alcohol intake, and exercise was very low (7%). On the basis of these results, high risk factors of arteriosclerosis such as hypertension, hyperlipidemia, or obesity are either directly or indirectly correlated each other. Therefore, it is difficult to predict outcomes for increasing or decreasing the risk factors by simply modulating a factor. Smoking, alcohol, and exercise both directly and indirectly affected major risk factors of arteriosclerosis. Therefore, correcting these variables is required to decrease risk factors. Finally, the relationship among other risk factors which have been known to be related with arteriosclerosis (diet, stress or hereditary) should be clarified in further studies.

• 대한의생명과학회지
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• 제18권2호
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• pp.87-95
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• 2012

Hypertension is a complex disease that results from the interaction of genetic and environmental influences and heritability is influenced by about one-third to one-half. However, the specific genetic variants determining risk for hypertension are still largely unknown. Here, we performed association analysis to elucidate the possible relations of genetic polymorphisms in ESR1 gene with blood pressure traits. By examining genotype data of a total of 3,804 women in the Korean Association REsource (KARE) study, we discovered the ESR1 gene polymorphisms are associated with blood pressure and hypertension. The highest significant polymorphisms were rs2982571 (${\beta}=-1.56$, $P=6.8{\times}10^{-3}$) with systolic blood pressure (SBP), rs9322335 (${\beta}=-0.61$, P=0.013) with diastolic blood pressure (DBP), and rs851985 (OR=0.78, CI: 0.65~0.94, $P=8.6{\times}10^{-3}$) with hypertension. In the 5 SNPs (rs2982571, rs851985, rs851983, rs851981, and rs851980), their ${\beta}$-values in SBP and/or DBP showed consistent trends with the odds ratios (ORs) of hypertension, and these 5 SNPs were composed with one LD block. Consequently, we found statistically significant SNPs in ESR1 gene that are associated with both blood pressure and hypertension traits. These results suggested that the individuals with the minor alleles of the 5 SNPs in the ESR1 gene may be less susceptible to the development of hypertension in the Korean women.

• 디지털융복합연구
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• 제14권7호
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• pp.309-319
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• 2016

보건의료데이터의 질적 수준을 향상시키기 위해서는 데이터 질 관리 알고리즘을 개발할 필요성이 있다. 이에 본 연구에서는 질환의 유병률, 입원율이 높은 고혈압 환자의 당뇨질환 동반에 관련된 데이터 질 관리 알고리즘을 개발하고자 하였다. 이를 위해 2011년, 2012년 퇴원손상심층조사 자료 중 고혈압 환자 61,199건을 추출하여 분석대상으로 하였다. 데이터 마이닝의 대화식 의사결정나무 방법과 Outlier Detection 방법론을 통해 데이터 질 관리 알고리즘 개발한 결과 고혈압 환자가 당뇨병을 동반상병으로 가지는데 영향을 미치는 요인으로는 성별, 연령, 당뇨병성 사구체 장애, 당뇨병성 망막병증, 당병성 다발성 신경병증 등이 있었다. 의사결정나무 결과에 따라 당뇨병을 동반상병으로 가질 확률 값이 80% 이상이거나, 20% 이하인 집단을 Outlier(극단치)로 정의하고, 고혈압 환자의 당뇨 동반에 대한 극단치를 가지는 6개 집단을 발견하였다. 이와 같이 Outlier(극단치) 집단에 포함되는 실제 데이터를 확인하여 데이터의 질적 수준을 향상 시킬 필요가 있다.

• 한국보건간호학회지
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• 제29권2호
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• pp.165-176
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• 2015

Purpose: This study was conducted to examine the relationships of depression symptom, self-esteem, and stress with health-related quality of life(HRQOL) in patients with hypertension registered to a community health center. Methods: This study was a correlational survey using a convenience sampling. A total of 110 patients diagnosed with hypertension were recruited from a health center in Gyeonggi-do. The questionnaires used were the Cardiovascular Disease Specific-HRQOL questionnaire, Center for Epidemiologic Studies Depression, Rosenberg Self-Esteem Scale, and Perceived Stress Scale. The acquired data were analyzed using IBM SPSS version 22.0. Multiple linear regression analysis was performed. Results: Moderate depression symptom(${\beta}=-.368$, p<.001), severe depression symptom (${\beta}=-.450$, p<.001), stress(${\beta}=-.339$, p=.001), and gender(${\beta}=-.148$, p=.049) were significant predictors for the HRQOL. Multiple linear regression showed that 51.8% ($R^2=.518$) of the variance in the HRQOL was explained. Conclusion: Based on these results, development of an intervention or education program, to decrease depression symptoms and stress is recommended. This may improve the HRQOL in patients with hypertension registered to a community health center.

• 농촌의학ㆍ지역보건
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• 제41권3호
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• pp.152-161
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• 2016

Objective: The purpose of this study was to develop a motivation-enhancing self-management program and apply to rural aged with hypertension to evaluate the applicability of the Program. Methods: The motivation-enhancing self-management program was on the evidence of Orem's self-care theory and Ford's Motivational system theory which consists of group education and tele-coaching conducted 12-week. The program evaluation was done by structured questionnaires of motivation (self-efficacy, perceived benefit, perceived barrier and emotional salience), self-care and blood pressure. There were totally 31 aged with hypertension in 2 rural areas enrolled in the program. Results: There was only perceived benefit statistically significant between the intervention and control group (t=2.05, p=.04) and self-care level was no difference between the two groups (t=0.21, p=.84) after program. But there are statistically significant differences of systolic blood pressure between the intervention and control group(t=-2.62, p=.01). Conclusion: The motivation-enhancing self-management program is necessary for the rural aged with hypertension, but it's needed modify and revise in the future study.

• 대한예방한의학회지
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• 제15권3호
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• pp.17-38
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• 2011

Objectives : This study aims to provide the fundamental information for future researches on combined medications of the oriental-western medicines or development of new Oriental medicine for hypertension. Methods : Every article related to hypertension was initially searched at journal web site, 'OASIS' and we finally analyzed 118 papers according to study types, kinds of herbal medicine, frequencies of herbal medicine, and results of researches. Results : Most studies were experiment researches which were composed of in vivo or in vitro. The formulas divided into 41 single and 99 complex prescriptions and total 218 medicinal materials were used in complex ones. The major effects of single prescriptions were decrease of the control of ACE activity and ANP concentration, while the effects of complex ones were various such as decrease of aldosteron concentration, decrease of epinephrine concentration, decrease of the heart rate, and decrease of dopamine concentration. Conclusions : More clinical studies based on scientific evidences should be done and the outcomes of this pilot study will contribute to development of Oriental medicines as substitute or combination for the western-hypertension remedies.

• The Korean Journal of Physiology
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• 제23권1호
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• pp.67-78
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• 1989

Since the atrial receptor was suggested to be involved in the control of extracellular fluid volume, it has been shown that the granularity of atrial cardiocytes can be changed by water and salt depletion, and that an extract of atrial tissue, when injected intravenously into anesthetized rats, causes a large and rapid increase in renal excretions of sodium and water. The immunoreactive atrial natriuretic peptide (ANP) has been found in the plasma of patients suffering from various cardiovascular diseases. A high level of ANP in the plasma has been reported in essential hypertension. Several studies on the effects of ANP on renal function and arterial blood pressure have presented contradictory results showing attenuated or accentuated responses. Thus, involvement of the ANP in the development of hypertension remains unresolved. Present study was undertaken to investigate whether the ANP is involved in the development of hypertension in two-kidney one-clip Goldblatt hypertensive rats. The plasma concentration of immunoreactive ANP appeared to be significantly elevated in hypertensive rats as compared with normotensive Goldblatt operated and sham-operated rats. Plasma renin concentration was higher in hypertensive rats than in normotensive rats, as observed in earlier experiments. Intravenous infusions of ANP resulted in increases of urine flow and urinary excretions of sodium and potassium in both hypertensive and normotensive rats. The renal response to ANP was markedly accentuated in Goldblatt hypertensive rats. The plasma concentration of ANP showed a linear relationship with the arterial blood pressure. Infusions of ANP reduced blood pressure both in hypertensive and normotensive rats. These results suggest that in Goldblatt hypertensive rats an elevation of ANP level in the plasma may not be a cause, but instead a consequence of hypertension, and that the renal responsiveness to the ANP is accentuated by some unknown mechanisms.

• 한국한의학연구원논문집
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• 제13권2호통권20호
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• pp.149-155
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• 2007

Objective : Using a spontaneously hypertensive rat (SHR) model of essential hypertension, this study investigated whether electroacupuncture (EA) could reduce early stage hypertension by examining whether EA increased nitric oxide (NO) levels in plasma, which compensates for elevated blood pressure (BP). Methods : EA was applied to the acupoint, Baekhoe (GV20), and to a non acupoint in the tail at 10 Hz and an intensity of 1 mA for 10 minutes on the first and fourth day of the week for three weeks under isoflurane anesthesia. In conscious SHR and normotensive Wistar Kyoto (WKY) rats, blood pressure was determined the day after EA treatment by the tail cuff method using an automatic BP monitoring system. We also measured NO concentration of blood serum in SHR and WKY. Results : Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were lower after 3 weeks of GV20 treatment than in non EA treated or non acupoint treated SHR rats. The NO level of plasma was significantly lower in hypertensive SHR than in normotensive WKY. EA prevented the augmentation of blood pressure, and also increased NO concentrations from $7.91{\pm}0.42$ ${\mu}M$ to $11.50{\pm}0.93$ ${\mu}M$ in SHR serum. Conclusions : We suggest that acupuncture may be an early intervention to delay the development of hypertension and enhance NO/NOS activity.

• Journal of Preventive Medicine and Public Health
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• 제33권2호
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• pp.199-207
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• 2000

농촌지역 성인들에서 고혈압 발생과 관련이 있는 위험요인을 조사하기 위하여 1996년 경상북도 청송군의 20세이상 성인 3,573명을 대상으로 면담조사와 신체검사를 실시하였다. 연구대상 코호트는 고혈압이 없는 2,580명으로 하였는데, 1년 후 1,781명(69.0%)의 추적조사가 완료되었다. 조사한 독립변수들은 일반적 특성(연령, 성, 교육수준, 경제적상태, 결혼상태), 고혈압 가족력, 식이, 술, 담배, 커피, 스트레스, 그리고 여성에서 경구용 피임약, 폐경상태가 추가되었다. 그리고, 키, 몸무게, 허리둘레, 엉덩이둘레, 초기혈압, 혈청 총 콜레스테롤이었다. 다중 로지스틱 회귀분석 결과, 남자에서는 연령의 비교위험도가 1.50(95% 신뢰구간; 1.15-1.96), 고혈압 가족력이 2.11(95% 신뢰구간; 1.04-4.26), 허리-엉덩이 둘레비가 2.09(95% 신뢰구간; 1.15-3.79), 초기 수축기 혈압은 120mmHg 미만을 기준으로 하였을 때 130-139mmHg가 3.34(95% 신뢰구간; 1.47-7.60)로 경계형이상 고혈압의 발생과 유의한 관련이 있는 위험요인이었다. 여자에서는 연령의 비교 위험도가 1.06(95% 신뢰 구간; 1.03-1.09), 추적 기간동안 새로이 폐경을 경험한 경우는 3.32(95% 신뢰구간; 1.01-10.87), 초기 수축기 혈압은 120mmHg미만을 기준으로 하였을 때 120-129mmHg가 2.00(95% 신뢰구간; 1.02-3.90), 130-139mmHg가 2.64(95% 신뢰구간; 1.34-5.20), 그리고 초기 이완기 혈압은 80mmHg미만을 기준으로 하였을 때 85-89mmHg가 4.09(95% 신뢰구간; 1.86-8.96)로 유의한 관련이 있는 위험요인이었다. 결론적으로 경 계형 이상 고혈압 발생과 관련된 위험요인으로는 남자에서는 연령, 고혈압 가족력, 허리-엉덩이 둘레비 그리고 높은 정상 혈압이었다. 여자에서는 연령, 폐경이 새롭게 일어난 경우 그리고 높은 정상 혈압이었다.

• 대한지역사회영양학회지
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• 제6권1호
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• pp.97-107
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• 2001

The clustering of insulin resistance with hypertension, glucose intolerance, hyperinsulinemia, increased triglyceride and decreased HDL cholesterol levels, and central and overall obesity has been called syndrome X, or the insulin resistance syndrome(IRS). To develop a nutrition service for IRS, this study was performed to evaluate the prevalence of each component of the metabolic abnormalities of IRS and analyze the clustering pattern of IRS among subjects living in the Taegu community. Participants in this study were 9234(mean age ; M/F 48/40yrs);63.5% were men, 24.4% were obese, 13.3% had hypertension. 3.7% had hyperglycemia, and 32.4% had hyperlipidemia. The IRS was defined as the coexistence of two or more components among metabolic abnormalities; obesity, hypertension. hyperglucemia and hyperlipidemia. The prevalence of IRS in Taegu was 19.2%(M/F:20.8%/16.4%), the clustering of these fisk variables was higher in advanced age group. Among the subjects of IRS having two of more diseases, 75.6% were obese, the pattern were similar in men and women. The younger, the higher the prevalence of obesity associated clustering patterns. The prevalence of obesity associated patterns among the hyperglycemia associated clustering patterns was 44.5%. The samples of the representative clustering patterns were obesity and hyperlipidemia (8.0%), hypertension and hyperlipidemia(3.2%), hypertension, obesity and hyperlipiemia(3.1%), hypertension and obesity(2.3%), and hyperglycemia and hyperlipidemia(0.8%). The clustering of obesity and hyperlipidemia until 50 year old groups, and the clustering of hypertension and hyperlipidemia in the 60 and 70 age groups were the most prevalent. We concluded that insulin resistance syndrome was a relatively common disorder in the Taegu community, and prevalence and the characteristics of the intervention strategies for IRS are desired, an effective improvement will be achieved.