• 한국산학기술학회논문지
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• 제11권6호
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• pp.2161-2168
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• 2010

본 연구는 행정자료인 건강보험 및 의료급여비용 청구자료를 이용하였으며, 일개지역(2개도, 남 북)에 개설 되어있는 전체 의료기관을 대상으로 진료일 기준 '08.7월~'08.12월(184일)동안 외래 방문이 1회 이상인 30세 이상의 수진자 485,953명을 대상으로 하였다. 진료지속성과 영향 요인을 분석한 결과 다음과 같다. 우리나라 성인 고혈압 환자의 평균 진료지속성 수준은 MMCI, $0.96{\pm}0.13$, MFPC $0.96{\pm}0.12$으로 높게 나타났다. 외래진료 지속성에 영향을 미치는 요인으로는 여성일수록, 55세~64세 이상 연령일수록, 동반상병이 있을수록 통계적으로 유의하게 낮았으며, 주이용기관이 상위 종별일수록 통계적으로 유의하게 MMCI와 MFPC 모두 높게 나타났다. 이 연구에서는 우리나라 성인 고혈압환자의 평균 진료지속성 수준은 높은 것으로 나타났으며, 여성, 64세 이상 연령 등 진료지속성이 낮은 대상자에 대한 관리가 필요할 것으로 보인다. 이 연구 결과는 우리나라 고혈압환자들의 건강관리 행태를 모니터하는 지표 및 국가의 고혈압관리사업의 성과지표로써 활용할 수 있을 것이다.

• 대한간호학회지
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• 제36권3호
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• pp.551-560
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• 2006

Purpose: This study was to develop and prove the effects of aself management compliance promotion program for primary hypertension patients who reside in rural communities. Method: The content of the self management compliance promotion program developed by this study was as follows: A leader trains patients as a group or individually, in walking, education and green tea therapy from the first to twelfth week. From the thirteenth to twenty fourth week, the patients should perform walking and green tea therapy by themselves. One hundred twenty subjects volunteered to participate in the study, who were among those registered as hypertension patients in the 14 community health clinics located in Chungcheongbuk-do. Result: Systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, triglyceride, step width, and degree of obesity decreased significantly. High-density lipoprotein cholesterol, step length, knowledge of hypertension, and self management compliance significantly increased, Conclusion: A self management compliance promotion program for primary hypertensive patients enhances biophysical index and knowledge on hypertension, thus ultimately suggesting a nursing intervention for promoting self management compliance.

• Journal of Nutrition and Health
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• 제32권4호
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• pp.407-418
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• 1999

The purpose of this study was to identify dietary factors related to the incidence of diabetes mellitus in Korea. The study consisted of 165 diabetic patients, male and female, aged 30 to 70 years and 198 healthy persons as controls. Diabetic patients who had been diagnosed with diabetes mellitus for less than five years before the study period were recruited from eight different hospitals located in Seoul, Korea. Socioeconomic status, state of illness, physical activity, food habits and food intake were assessed. Food intake was assessed by food frequency questionnaire method using a 105-food frequency questionnaire developed for diabetic patients. The stress and activity indices of diabetic patients were not significantly different from control, but alcohol consumption and smoking levels were higher in diabetics than controls. Other diseases of male diabetic patients included liver diseases, digestive system diseases, and hypertension, while those of female diabetics were hypertension, neuralgia, arthritis and digestive system diseases. These disease patterns are different from Western countries whose most common complications are hypertension and hyperlipidemia. More irregular and less varied meals were found in the diabetic group compared to the control group, suggesting that diabetic patients have generally undesirable food habits. Otherwise, food and nutrient intake of diabetics did not differ greatly from the control group. It was found that diabetic patients consumed more cereals and less fruit than the control group, and also that male diabetics consumed more alcohol. The carbohydrate : protein : fat energy distribution ratio was 61.7 : 15.8 : 22.5 in male patients and 65.1 : 14.9 : 19.7 in female patients. Discriminant analysis showed that diabetes risk factors differed with sex. In male patients, the important factors were body mass index(BMI), vitamin C intake, family diabetic history and vegetable intake, while in female patients they were BMI, cereals intake, carbohydrate intake, vitamin C intake, stress, food habits and Ca intake. These results show that excessive intake of energy and fat are not the major causal factors in Korean NIDDM. Therefore, the diabetes risk factors of Western countries may not directly apply to Koreans. Mors study is needed to clarify the risk factors of Korean NIDDM.

• 한국환경성돌연변이발암원학회지
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• 제23권1호
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• pp.7-10
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• 2003

Hypertension is characterized by multiple genetic and environmental factors. To establish the genetic basis of hypertension in Koreans, we investigated the genetic variations of dopamine D3 receptor (DRD3) gene in the Korean patients with hypertension and normotensive controls. There were no significant differences in the genotype and allele frequencies of Bal I RFLP in the DRD3 gene between two groups, respectively (P > 0.05). Our finding shows lack of association between a genetic marker of DRD3 gene and hypertension, suggesting that the genetic variation of DRD3 gene does not playa major role in the determination of hypertension in Korean population. Further studies in other ethnic groups will be required.

• Industrial Engineering and Management Systems
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• 제13권4호
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• pp.449-453
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• 2014

Chronic diseases including hypertension and its complications are major sources causing the national medical expenditures to increase. We aim to predict the risk of hypertension complications for hypertension patients, using the sample national healthcare database established by Korean National Health Insurance Corporation. We apply classification techniques, such as logistic regression, linear discriminant analysis, and classification and regression tree to predict the hypertension complication onset event for each patient. The performance of these three methods is compared in terms of accuracy, sensitivity and specificity. The result shows that these methods seem to perform similarly although the logistic regression performs marginally better than the others.

• 한국한의학연구원논문집
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• 제14권1호
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• pp.67-72
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• 2008

Objectives : The purpose of the study was to determine the effects of a 4 weeks Meridian Tai Ji exercise treatment on blood pressure reducing in hypertensive patients. Methods : We measured the blood pressure of 3 patients who were visited in the Gwacheon Health center from 21th November 2007 to 17th December 2007. Eligible participants had systolic blood pressure ${\geq}$ 120 mmHg or diastolic blood pressure ${\geq}$ 80 mmHg with antihypertensive drug. Blood pressure measurements were after the patient had been in rest for at least 10 minute. Twelve sessions of Meridian Tai Ji exercise treatment over 4 weeks were performed in the patients. Blood pressure were measured twice before and after each session. Results : After 4 weeks, blood pressure reduction was observed in the treatment patients, with an average decline of systolic blood pressure up to 5.67 mmHg and diastolic blood pressure up to 0.17 mmHg. But, it was not statistically significant. Blood pressure increased between measurements taken before and after an Meridian Tai Ji exercise treatment session, although individual responses were quite variable. No significant difference was found in the immediate effect. Conclusion : Twelve sessions of Meridian Tai Ji exercise treatment do not seem to control hypertension. Further research is required to determine whether Meridian Tai Ji exercise treatment can enhance clinical management of hypertension if it is used in combination with more enrolled participants, over longer periods, or randomized controlled trial.

• 한국치위생학회지
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• 제18권5호
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• pp.653-664
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• 2018

Objectives: The purpose of this study was to examine the association between two major oral diseases and cardiovascular diseases. Methods: Data from the 6th Korean National Health and Nutrition Examination Survey (2013-2015) were used. The study included 12,754 adults, aged ${\geq}19years$, who participated in the questionnaire survey of health related to hypertension, stroke, myocardial infarction, and angina pectoris as well as completed blood tests, anthropometry, and oral examination. Statistical analyses included complex sample frequency, complex sample general linear, complex sample cross-tabulation, and complex sample logistic regression analyses. Results: With respect to the number of Decayed-Missing-Filled-Teeth(DMFT ), patients with hypertension (DMFT 8.05), stroke (DMFT 8.66), and angina pectoris (DMFT 8.24) showed a DMFT score of >2, compared with those who did not have these diseases (p<0.05). Patients with hypertension, stroke, myocardial infarction, and angina pectoris presented an approximately 2.7, 3.5, 4, and 3 times higher incidence of periodontal diseases, respectively, than those who did not (p<0.05). Based on the analysis of the relationship between the number of DMFT and cardiovascular diseases, patients with cardiovascular diseases had a risk of 1.033 higher DMFT than those who did not (p<0.05). As per the analysis of the relationship between periodontal diseases and cardiovascular diseases, patients with cardiovascular diseases had a 2.969 higher risk of periodontaldiseasesthanthosewithout them (p<0.05). Conclusions: Two major oral diseases were found to be associated with cardiovascular diseases. Therefore, to prevent these major oral diseases in patients with cardiovascular diseases, oral hygiene management must be actively performed.

• 보건행정학회지
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• 제23권4호
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• pp.427-433
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• 2013

Background: This study was conducted to evaluate the factors affecting adherence in patients with hypertension and type 2 diabetes mellitus before and after a clinic based patient incentive program in Incheon. Methods: An observational follow-up study was done for 28,355 patients in one registered group and 245,598 patients in a non-registered group from March 16th 2009 to December 31th 2010 in Incheon. The registration, mandatory laboratory tests and number of clinic visits were collected by merging the Incheon Chronic Disease Management System data and the National Health Insurance Corporation (NHIC) data. As a measure of patient adherence, we used a variable of prescription days from the NHIC and defined above 80% of average prescription days as an appropriate patient adherence. Repeated measures analysis of variance and logistic regression were used to analyze the differences in patient adherence and factors affecting adherence. Results: The changes in prescription days for the registered group are larger than for the non-registered group. In the logistic regression model, including the variables with sex, age, income status and number of clinic visits, the registered group exhibited a higher Odds ratio in the patient adherence. Conclusion: This study revealed the association between registration and appropriate patient adherence in patients with hypertension or type 2 diabetes mellitus.

• Journal of Korean Neurosurgical Society
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• 제61권6호
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• pp.767-773
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• 2018

Three male patients diagnosed with surfer's myelopathy (19-30 years) were admitted to our hospital. All three patients were novice surfers showing a typical clinical course of rapid progression of paraplegia following the onset of back pain. Typical history and magnetic resonance imaging features indicated the diagnosis of surfer's myelopathy. Two patients received high-dose steroid therapy and the other was treated with induced hypertension. One patient treated with induced hypertension showed almost full recovery; however, two patients who received high-dose steroid therapy remained completely paraplegic and required catheterization for bladder and bowel dysfunction despite months of rehabilitation. Our case series demonstrates the potentially devastating neurological outcome of surfer's myelopathy; however, early recovery in the initial 24-72 hours of presentation can occur in some patients, which is in accordance with previous reports. Ischemic insult to the spinal cord is thought to play a crucial role in the pathophysiology of surfer's myelopathy. Treatment recommendations include hydration, induced hypertension, early spinal angiography with intra-arterial intervention, intravenous tissue plasminogen activator, and high-dose steroid therapy; however, there is no standardized treatment option available. Early recovery appears to be important for long-term neurological outcome. Induced hypertension for initial treatment can be helpful for improving spinal cord perfusion; therefore, it is important for early and long-term neurological recovery. Education and awareness are essential for preventing surfer's myelopathy and avoiding further deterioration of neurological function.

• 대한한의학회지
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• 제40권3호
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• pp.1-20
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• 2019

Objectives: This study aims to investigate the effects of Korean Medicine Hospital Utilization (KMHU) on major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and death in hypertensive patients taking antihypertensives. Methods: Using the Korean National Health Insurance Service-National Sample Cohort database, this study identified and diagnosed 68,457 hypertensive patients taking antihypertensives between 2003 and 2006. They were divided into KMHU and non-KMHU groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke, or death. After propensity score matching (PSM), there were 18,242 patients each in the non-KMHU and KMHU groups. We calculated the incidence rate, hazard ratio (HR), and 95% confidence interval (CI) for MACE, myocardial infarction, stroke, and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. Results: After PSM, the HRs for MACE (HR: 0.84, 95% CI: 0.81-0.87), all-cause mortality (HR: 0.75, 95% CI: 0.72-0.79), and myocardial infarction (HR: 0.90, 95% CI: 0.83-0.97) were significantly lower in the KMHU group than in the non-KMHU group. Moreover, the HRs for stroke-related mortality, haemorrhage and ischaemic stroke-related mortality, and ischaemic heart disease-related and circulatory system disease-related mortality were significantly lower in the KMHU group than in the non-KMHU group. Conclusions: On long-term follow-up observation, this study supported the effect of KMHU for managing hypertension and reducing the burden of cardiovascular diseases.