• Korean Journal of Family Medicine
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• v.39 no.6
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• pp.347-354
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• 2018

Background: BMI alone may not serve as an index of obesity because it does not reflect body composition. The present study aimed to compare arterial stiffness as assessed by the brachial-ankle pulse wave velocity (ba-PWV) among groups defined by body fat percentage (pBF) and BMI. Methods: This cross-sectional study was based on 1,700 participants (1,044 men and 656 women) who completed a health screening examination at a national hospital between January 2011 and February 2016. Participants were divided into four groups according to BMI and pBF: normal fat and normal weight (NFNW); excessive fat and normal weight (EFNW); normal fat and obese (NFO); and excessive fat and obese (EFO). The ba-PWV and other cardiometabolic factors were compared among the four groups in men and women separately. Results: For both sexes, the NFNW group had a lower metabolic risk compared to that in the other groups (EFNW, NFO, and EFO). After adjusting for multiple variables, the NFO males had a significantly lower ba-PWV compared to those in the other groups, including NFNW males. The NFO group had significantly more skeletal muscle mass and muscle mass compared the other groups (P<0.05). Among women, the NFNW group had a significantly lower ba-PWV compared the other groups, even after adjusting for multiple variables. Conclusion: Lower pBF in obese men may be associated with improved cardiovascular risk.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.9 no.1
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• pp.59-68
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• 2005

Background and purpose: Cardiovascular disease will undoubtedly rise along with the aging of the 'baby-boom' generation. The purpose of this study is to find the new index of the cardiovascular aging. Methods: The effects of aging on the heart and the arterial system are surveyed in the point of structure and function. Results: Arterial stiffening is due to the fatiguing effects of periodic stress on the arterial wall and is the main reason for increasing pulse wave velocity. The systolic hypertension is caused by the early return of wave reflection. The increased after-load by the arterial change leads to the development of left ventricular hypertrophy. The reduction in left ventricular compliance cause the impairments of the diastolic function. In contrast to the lower limb, aging effect in the upper limb are almost due to the ascending aortic pressure wave and the reflected wave from the lower limb. Conclusion: We have the following points. (1) The change of physiological pulse pattern by age can be explained by the early returning of reflected wave. (2) The atrial pulse in old age are generated by the left ventricular hypertrophy.

• Journal of IKEEE
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• v.11 no.3
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• pp.108-116
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• 2007

This paper proposed an analyzable parameter and its analytic method to provide more accurate information than currently employed 4 channels system which uses pulse wave velocity (PWV) information of the volume pulse wave measured from 4 arterial channels for the characterization of arterial vessel. In order to verify the volume pulse waves on 4 sites were simultaneously acquired subjects aged from 12 to 81 years old. and the proposed parameters were extracted from time (UT) was then compared with blood pressure. Then, the regression analyses were done relationships among the proposed parameter and others, such as aging, pulse transit time pressure (BP). The followings are the results of linear regression analysis of the proposed parameter for total 50 normal subjects. We selected any two subjects (58 years and 27 years) and measured PPG (photoplethysmogram) and BP of before and after exercise. The coefficient of correlations between BP and UT observed was -0.928 for 50 years subject, and -0.922 for 20 years subject. For total 50 normal subjects, in case of correlation between the pulse transit time and BP, the result showed -0.170 on left side and -0.233 on right side, and the coefficient value of correlation between the pulse transit time and UT was -0.607 on left side and -0.510 on right side. UI is strongly correlated with the pulse transit time than BP. Hence, we believe that the proposed parameter is related with the index of arterial stiffness.

• The Journal of the Society of Stroke on Korean Medicine
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• v.7 no.1
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• pp.17-22
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• 2006

Objectives : Uwhangchungsimwon (UC) is one of the famous herbal medicine frequently used for stroke, hypertension, and atherosclerosis, etc. Therefore, we intended to examine if UC could have therapeutic effect on arterial stiffness by assessing Cardio-Ankle Vascular lndex (CAVI). Methods : We enrolled 38 healthy male subjects (28±4.41 years old) and divided them into two groups (UC and control group). The UC group (N=22) were treated with 1 pill of UC and monitored by CAVI every hour for 6 hours. The control group(N=16) did not receive any medicine and were also monitored by CAVI the same manner as the UC group. In both group, we also assessed each subject's Yin-Yang pattern score by the diagnostic scoring system. In analysis, we compared the difference of CAVIs between the UC and the control group considering subject's Yin-Yang pattern. Results : There was no significant difference in the change of CAVI between the UC and the control group. After excluding Yang-pattern subjects in both group, however, we could observe that CAVI decreased significantly 5 hours after UC administration compared with the corresponding CAVI in the control group (P=0.025). In the repeated measure analysis, the between-subjects effect had statistical significance (P=0.035). Conclusion : According to these results, we suggest that UC have therapeutic effect on arterial stiffness especially after taking oriental medical diagnosis into consideration.

• Journal of Biomedical Engineering Research
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• v.32 no.2
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• pp.109-117
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• 2011

Assuming that photons absorbed by a vessel do not have acute variations, DC component reflect the basal blood volume (or diameter) before blood pulsation. Vascular stiffness and reflection is influenced by changes in basal blood volume (or diameter). This paper describes analysis of the characteristic variations of vascular stiffness, according to relative variations in DC components of the PPG signal (25-75%). For quantitative analysis, we have used parameters that were proposed previously, reflection and stiffness index, and the second derivative of PPG waveform, b/a and d/a. Significantly, the vascular stiffness and reflections were increased according to increase in DC component of the PPG signal for more than about 3% of baseline values. The systolic blood pressure were increased from $113.1{\times}13.18$ to $116.2{\times}13.319$ mmHg, about 2.76% (r = 0.991, P < 0.001) and the AC component of the PPG signal were decreased from $2.073{\times}2.287$ to $1.973{\times}2.2038$ arbitrary unit, about 5.09% (r = -0.993, P < 0.001). It is separated by DC median and correlation analysis was performed for analyzing vascular characteristics according to instantaneous DC variations. There are significant differences between two correlation coefficients in separated data.

• Journal of Electrical Engineering and Technology
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• v.2 no.1
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• pp.136-141
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• 2007

The Purpose Of This Paper Is To Use A Tactile Sensor To Compensate The Error Rate. Most Automated Sphygmomanometers Use The Oscillometric Method And Characteristic Ratio To Estimate Systolic And Diastolic Blood Pressure. However, Based On The Fact That Maximum Amplitude Of The Oscillometric Waveform And Characteristic Ratio Are Affected By Compliance Of The Aorta And Large Arteries, A Method To Measure The Artery Stiffness By Using A Tactile Sensor Was Chosen In Order To Integrate It With The Sphygmomanometer In The Future Instead Of Using Photoplethysmography. Since Tactile Sensors Have Very Weak Movements, Efforts Were Made To Maintain The Subject's Arm In A Fixed Position, And A 40hz Low Pass Filter Was Used To Eliminate Noise From The Power Source As Well As High Frequency Noise. An Analyzing Program Was Made To Get Time Delay Between The First And Second Peak Of The Averaged Digital Volume Pulse(${\Delta}t_{dvp}$), And The Subject's Height Was Divided By ${\Delta}t_{dvp}$ To Calculate The Stiffness Index Of The Arteries($Si_{dvp}$). Regression Equations Of Systolic And Diastolic Pressure Using $Si_{dvp}$ And Mean Arterial Pressure(Map) Were Computed From The Test Group (60 Subjects) Among A Total Of 121 Subjects(Age: $44.9{\pm}16.5$, Male: Female=40:81) And Were Tested In 61 Subjects To Compensate The Error Rate. Error Rates Considering All Subjects Were Systolic $4.62{\pm}9.39mmhg$, And Diastolic $14.40{\pm}9.62mmhg$, And Those In The Test Set Were $3.48{\pm}9.32mmhg,\;And\;14.34{\pm}9.67mmhg$ Each. Consequently, Error Rates Were Compensated Especially In Diastolic Pressure Using $Si_{dvp}$, Various Slopes From Digital Volume Pulse And Map To Systolic-$1.91{\pm}7.57mmhg$ And Diastolic $0.05{\pm}7.49mmhg$.

• Clinical and Experimental Pediatrics
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• v.57 no.12
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• pp.520-525
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• 2014

Purpose: Childhood obesity is an increasing public health issue worldwide. We examined dietary patterns among adolescents in a dormitory school, identified obese adolescents and tried to intervene to improve food habits and physical activity. Methods: We conducted an experimental prospective longitudinal study based on 36 obese (body mass index $[BMI]{\geq}95th$ percentile) adolescents (aged 12-18 years) compared with controls (healthy children: normal age-appropriate BMI ($BMI{\leq}85th$ percentile). Six months' intervention included lifestyle-modification counseling (once a week by a clinical dietician), and an exercise regimen twice a week, 60 minutes each time, instructed by a professional pediatric trainer). Both groups underwent baseline measurements at the beginning of the study and 6 months later (arterial stiffness, blood pressure, pulse, weight and height, hemoglobin, creatinine, liver enzymes, highly sensitive C-reactive protein and complete lipid profile). Results: Twenty-one participants completed the study. Low compliance from participants, school staff and parents was observed (participation in planned meetings; 71%-83%). BMI significantly decreased from $32.46{\pm}3.93kg/m^2$ to $30.32{\pm}3.4kg/m^2$ (P=0.002) in the study group. Arterial stiffness was not significantly different between the 2 groups and did not change significantly after 6 months' intervention (P=0.494). No significant changes in CRP and lipid profile were observed after the intervention. Conclusion: Making lifestyle modifications among adolescents in a dormitory school is a complex task. Active intervention indeed ameliorates BMI parameters. However, in order to maximize the beneficial effects, a multidisciplinary well-trained team is needed, with emphasis on integrating parents and the school environment.

• Korean Journal of Acupuncture
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• v.27 no.2
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• pp.107-120
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• 2010

Objectives : The aim of this study is to measure pulse waveforms by applying 5-level graded pressure, and selecting optimum pulse waveforms. Also to proposing the possibility of using AW(Area of the 1/3 upper height of h1) rate in respect to AT(Total Area) for risk assessment of hypertension or arteriosclerosis is another aim of the study. Methods : Pulse waveforms of normotensive were measured by 5-level graded pressure. The pulse waveforms well reflecting properties of blood vessel(having the largest h1) were selected for optimum pulse waveforms. Various parameters(h-parameter, t-parameter, and others) of optimum pulse waveforms were analyzed. AIx(Augmentation index) was calculated by height-parameters to assess arterial stiffness. The area rate of the 1/3 upper height for h1 in respect to total area was analyzed according to aging. Results : According to aging 1. in height-parameter, h2 and h3 were increased but h5 was decreased. 2. In time-parameter, t2, t3, and t5 were getting short. 3. Area of systolic period was increased, and that of diastolic period decreased. 4. AIx rose by aging. 5. AW was significantly increased despite no changes in AT. Conclusions : By analyzing optimum pulse waveforms of 5-level graded pressure method, we could complement weakness of single graded pressure method. Also, possibility of applying the AW rate to risk assessment of hypertension or arteriosclerosis was confirmed in normotensive population which might not be assessed by AIx.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.5
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• pp.243-250
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• 2016

The body composition and arterial compliance with advanced age increase the risks of cardiovascular diseases, but the elderly can perform rhythm exercise easily, which may positively influence their body composition and arterial compliance. Therefore, this study examined the effects of rhythm exercise training on the body composition and arterial compliance in elderly females. The subjects (n=20) were assigned randomly to either an exercise group (n=10, EX) or non-exercise control group (n=10, CON). The rhythm exercise training for 12 weeks consisted of 3 sessions per week with 60 minutes per session. In addition, the intensity was set to 11-14 of the Borg scale (6-20). The body composition and arterial compliance (pulse wave velocity (PWV)) were measured before and after training. The skeletal muscle mass in the EX was increased significantly (p=0.04) and the right (p=0.002) and left side (p=0.02) of the PWV in the EX were decreased significantly, but the skeletal muscle and both sides of the PWV in the CON were not changed. Elderly females could easily perform rhythm exercise training, which resulted in improvements of the skeletal muscle mass and arterial compliance. Therefore, rhythm exercise training may prevent or delay sarcopenia and reduce the risk of cardiovascular diseases.

• Journal of Preventive Medicine and Public Health
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• v.44 no.6
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• pp.260-266
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• 2011

Objectives: We evaluated the association between common carotid artery intima-media thickness (CCA-IMT), brachialankle pulse wave velocity (baPWV), carotid plaque, and peripheral arterial disease (PAD) as indicators of macroangiopathy and diabetic retinopathy as an indicator of microangiopathy in type 2 diabetic patients. Methods: We analyzed 605 type 2 diabetic patients registered at a public health center in Korea. Following overnight fasting, venous blood and urine samples were collected and analyzed. The CCA-IMT, levels of carotid plaque, baPWV, and ankle-brachial index (ABI) of the subjects were assessed. We used non-mydriatic fundus photography to diagnose diabetic retinopathy. Multiple logistic regression analyses were used to evaluate the association between macroangiopathy and diabetic retinopathy. CCA-IMT and baPWV were divided into tertiles: CCA-IMT, 0.39 to 0.65 mm, 0.66 to 0.78 mm, and 0.79 to 1.30 mm; baPWV, 9.9 to 15.8 m/s, 15.9 to 18.9 m/s, and 19.0 to 38.0 m/s. Results: The association between baPWV and diabetic retinopathy remained significant after adjustment, with an increasing odds ratio (OR) in the second tertile (OR, 2.41; 95% confidence interval [CI], 1.27 to 4.55) and the third tertile (OR, 4.63; 95% CI, 2.33 to 9.21). No significant differences were observed in carotid plaque, PAD, and each tertile of CCA-IMT. Conclusions: BaPWV was associated with diabetic retinopathy, while CCA-IMT, carotid plaque, and PAD were not. This study suggests that the association between macroangiopathy and microangiopathy may be attributable to functional processes rather than structural processes within the vascular system.