• Title/Summary/Keyword: cardio-cerebrovascular

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Prevalence and Management of Dyslipidemia, Hypertension, Diabetes Among Adults in Gangwon-do, Korea: the 2013-2014 KNHSP (강원도 성인의 이상지질혈증, 고혈압, 당뇨병의 유병률과 관리: 국가건강검진(2013-2014) 자료의 분석결과와 시사점)

  • Jang, Sungok;Lee, Jongseok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.1
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    • pp.625-636
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    • 2017
  • Dyslipidemia, hypertension, and diabetes are well-established risk factors for cardio-cerebrovascular disease (CVD). Although the prevalence of dyslipidemia among Korean adults is very high, its management is known to be poor. The aim of this study was to assess the prevalence, awareness, treatment, and control rates of dyslipidemia among adults aged 30 years and older in Gangwon-do, Korea. Analysis included 58,121 adults (29,123 males and 28,998 females) participating in the 2013-2014 Korea National Health Screening Program (KNHSP). Dyslipidemia was defined according to the treatment criteria rather than the diagnostic criteria in Korea. Therefore, high-low-density lipoprotein cholesterol (LDL)-cholesterolemia was deemed present in individuals with LDL-cholesterol levels that exceeded the appropriate risk-based threshold. The age-standardized prevalence was highest in dyslipidemia (32.5%), followed by hypertension (25.1%), and diabetes (9.4%). The awareness rate was 76.7% for hypertension and 74.7% for diabetes, but only 10.6% for dyslipidemia. The lowest patient treatment was found for dyslipidemia (9.4%). The control rate among those undergoing treatment was highest for hypertension (75.8), followed by dyslipidemia (63.3%), and diabetes (43.9%). The higher CVD-risk categories showed lower control rates of hyper-LDL-cholesterolemia. The prevalence of dyslipidemia was higher than hypertension and diabetes, but awareness and treatment rates were lower. Our findings indicate there is a wide gap between the prevalence of dyslipidemia and subsequent treatment, which suggests that effective strategies are required to improve dyslipidemia management. It would be worthwhile to strengthen the follow-up management of patients with dyslipidemia in the KNHSP, especially for the high risk group of CVD.

Effects of an Educational Program for the High Risk Group of Cardio-cerebrovascular Disease: Awareness of the Warning Signs and Symptoms of Acute Myocardial Infarction and Stroke in the Aged at Senior Centers (심뇌혈관질환 고위험군 대상 교육프로그램의 효과: 경로당노인의 심근경색과 뇌졸중에 대한 경고증상 인지도)

  • Song, Jung-Kook;Park, Hyeung-Keun;Hong, Seong Chul
    • Journal of agricultural medicine and community health
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    • v.40 no.3
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    • pp.126-136
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    • 2015
  • Objectives: This study was performed to investigate the effects of a health education program for the aged on knowledge about the warning signs and symptoms of acute myocardial infarction and stroke. Methods: Data from 337 elderly people (159 participated and 178 non-participated) at senior centers in Jeju-si were collected by 1 to 1 interview from January to March 2012, one year after the education program provided. Two stages of study were performed: Cross-sectional, case-control study on the level of knowledge about the warning signs and symptoms; and multivariate logistic regression to fine out predictors of optimal awareness. Results: No significant discrepancy of knowledge level between case and control group was found. The knowledge level as high as a surge was shown in both groups one year later. A surge of knowledge had been shown after the education provided in one month. The factors affecting the optimal level of knowledge were education (Odds ratio 3.01; Confidence Interval 1.72-5.26; P-value <0.001) and 7 days of watching TV news per week (2.97; 1.68-5.23; P<0.001). However, participation in the health education was not significant (1.60; 0.98-2.61; P=0.059). Conclusions: The effects of a targeted program in high-risk groups for cardio-cerebrovascular disease are only guaranteed in the enhancement by a population-based mass-media education campaign.

A Retrospective Study on the Effect of 1-Year Clozapine Administration on Platelet Activity in Patients with Schizophrenia or Schizoaffective Disorder (조현병/조현정동장애 환자에서 1년간의 Clozapine 투여가 혈소판 활성도에 미치는 영향에 관한 후향적 연구)

  • Jang, EunJa;Lee, Jong Wook;Kim, Seung-Jun;Oh, Hong-Seok;Im, Woo Young;Lee, Na-Hyun;Kim, Ji-Woong
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.36-41
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    • 2020
  • Objectives : Clozapine has been known to increase the possibility of developing cardio/cerebrovascular diseases, and the platelet activation has been deemed to be related to the occurrence of them. In author's previous study, we observed the increase of platelet activity with short-term clozapine administration. This study was conducted, as a follow-up study, to investigate the effect of clozapine on the platelet activity when administered continuously for long-term period of time of 1 year. Methods : The medical records of the patients with schizophrenia or schizoaffective disorder who were treated with clozapine for 1 year were retrospectively reviewed. The degree of platelet activation was assessed by measuring the mean platelet component. Results : Total of 24 patients were enrolled. 9 of them (37.5%) were male and 15 of them (62.5%) were female. In the Wilcoxon sign-ranks test, no significant change was observed between the mean platelet factor values at the beginning and at the end of one year. Conclusions : No significant changes of mean platelet activity were observed after continued administration of clozapine for 1 year. Considering the author's previous findings that observed a prominent decrease of mean platelet component after short-term clozapine administration, the result of this study suggests the possibility that the activity of the platelet may change depending on the duration of the clozapine administration.

Effects of Chungpyesagan-tang on arterial stiffness and pulse pressure in acute stroke patients (청폐사간탕(淸肺瀉肝湯)이 급성기 중풍환자의 동맥경직도 및 맥압에 미치는 영향)

  • Park, Young-Min;Hong, Jin-Woo;Shin, Won-Jun;Jeong, Dong-Won;Kim, Seok-Min;Bae, Hyung-Sup;Kim, Young-Suk;Moon, Sang-Kwan;Jung, Woo-Sang;Cho, Ki-Hoo
    • The Journal of Internal Korean Medicine
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    • v.27 no.2
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    • pp.416-428
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    • 2006
  • Objectives : Arterial stiffness and pulse pressure are related to cardiovascular and cerebrovascular survival and longevity. This study is aimed at examining the effects of Chungpyesagan-tang on arterial stiffness and Pulse pressure in acute stroke Patients. Methods: The subject of this study was acute strike Patients within 1 week after ictus, with Cardio-ankle vascular index(CAVI) higher than 9.0. They were divided into two groups: A treatment group (n=44) and a control group(n=46). For two weeks, Chungpyesagan-tang was given to the former, other herbal medicines to the latter. used for stroke patients for the control group for 2 weeks. At the end of first and second week, CAVI, pulse Pressure, National Institute of Health stroke scale(NIHSS), Modified Barthel Index(MBI) were measured. Serum lipid Profile, aspartate transaminase(AST), alanine transaminase(ALT). blood urea nitrogen(BUN), creatinine were also measured at the end of the study. Results : After 2 weeks, CAVI and Pulse Pressure in Chungpyesagan-tane group were significantly tower than those in the control group(P<0.05). NIHSS and MBI were improved in both groups. But there was no significant difference between the treatment group and the control group in terms of the NIHSS and MBI. Conclusions : We suggest Chungpyesagan-tanghas desirable effects on arterial stiffness and Pulse Pressure of acute stroke patients. It can improve morbidity and mortality of patients on the basis of influencing vascular stiffness and increased pulse pressure.

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Friedewald-Estimated Versus Directly Measured LDL-Cholesterol: KNHANES 2009-2010 (LDL-콜레스테롤의 Friedewald 계산값과 실측값 비교: 국민건강영양조사 2009-2010)

  • Jang, Sungok;Lee, Jongseok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.8
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    • pp.5492-5500
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    • 2015
  • Low-density lipoprotein cholesterol (LDL-C) is a major modifiable risk factor for cardio- cerebrovascular disease. In clinical practice, however, it is primarily calculated using the Friedewald formula as a cost-effective method. The aim of this study was to compare Friedewald-estimated and directly measured LDL-C values and assess the concordance in guideline LDL-C risk classification between the two methods. The data were derived from the 2009 and 2010 Korea National Health and Nutrition Survey (KNHANES). Analysis was done for 4,319 subjects with lipid panels-total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), directly measured LDL-C using an enzymatic homogeneous assay, and triglycerides (TG). For subjects with TG lower than 400 mg/dL, Friedewald-estimated and directly measured LDL-C were highly correlated (r = 0.958, p < 0.001) and overall concordance was 82.7%. As TG increased, overall concordance decreased. Overall concordance was 85.4% at TG lower than 150 mg/dL; 78.2% at TG of 150-199 mg/dL; and 71.4% at TG of 200-399 mg/dL. The Friedewld equation tended to overestimate LDL-C when TG are of < 150 mg/dL; however, underestimate LDL-C when TG are of ${\geq}150mg/dL$. As a result, Friedewald estimation misclassified 382 subjects (9.1%) in a higher category versus 348 subjects (8.3%) in a lower category. Our findings suggest that overestimation of LDL-C by the Friedewald formula can be a great problem as well as underestimation.

Anti-obesity effect of Ramulus mori extracts and stilbenes in high fat dietfed C57BL/6J mouse (고지방식이를 급여한 C57BL/6J 마우스에서 상지추출물과 스틸벤 화합물의 항비만 효능 연구)

  • Park, Jeong-Eun;Lee, Geon-Hee;Kim, Juhee;Choi, Sang-Won;Kim, Eunjung
    • Journal of Nutrition and Health
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    • v.53 no.6
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    • pp.570-582
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    • 2020
  • Purpose: Obesity is a risk factor for various adult diseases such as type 2 diabetes, cardio-cerebrovascular disease, and cancer. With an increasing obesity population worldwide, the prevention of obesity with natural components has emerged as an alternative health care strategy. Ramulus mori (Sangzhi, RM) is widely used as a traditional herbal medicine in East Asia. It contains various phytochemicals, including stilbenes and 2-arylbenzofurans. In this study, we compared the anti-obesity effects of RM extracts and its major stilbene components (mulberroside A [MSA] and oxyresveratrol [ORT]) in high fat diet (HFD)-fed obese mice. Methods: Five week-old, male C57BL/6J mice were grouped into 7 experimental groups: normal diet (ND), HFD, HFD + 1% RM water extracts (MW), HFD + 0.1% MSA, HFD + 1% RM ethanol extracts (ME), HFD + 0.1% ORT, and HFD + 1% Garcinia cambogia extracts (GC) as a positive control. All mice were fed experimental diet for 13 weeks. Results: Compared to the HFD group, total body weight and weekly body weight gain were significantly decreased in the ME, ORT, and GC groups. Glucose tolerance level was significantly decreased in all experimental groups, whereas plasma insulin level was decreased in MSA, ME, ORT and GC groups. Plasma glucose, triglyceride (TG), and total cholesterol levels were significantly decreased, whereas high-density lipoprotein cholesterol levels were increased in the MSA, ORT, and GC groups. Hepatic TG accumulation was also significantly decreased in the MSA, ME, ORT, and GC groups. Adipose tissue weight and size of adipocytes were significantly decreased in the MSA, ME and ORT groups, and were comparable to values obtained in the GC group. The levels of adiponectin and SREBP1c mRNA expressions were increased in the ORT and GC groups. Conclusion: These results indicate that ME, ORT and MSA exert significant anti-obesity effect, and have the potential to be developed as a weight control ingredient of functional foods.

The Effect of Acanthopanax sessiliflorum Cheonghyeol Plus on NF-κB and MAPKs Signaling and Vascular Attachment Factors (오가피청혈플러스가 NF-κB 및 MAPKs 신호전달체계와 혈관부착인자 등에 미치는 영향)

  • Lee, Ji-won;Choi, Gyu-cheol;Bae, Ji-eun;Yoo, Ho-ryong;Kim, Yoon-sik;Seol, In-chan
    • The Journal of Internal Korean Medicine
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    • v.41 no.6
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    • pp.967-983
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    • 2020
  • Objective: This study was performed to investigate the effect of Acanthopanax sessiliflorum Cheonghyeol plus (ASCP) on NF-κB and MAPK signaling and vascular adhesion factors associated with dyslipidemia in human umbilical vein endothelial cells (HUVECs). Methods: We measured the scavenging activity of DPPH radical and ABTS radical by ASCP in HUVECs. We measured the protein expression levels of NF-κB, IκBα, ERK, JNK, and p38 after treatment of HUVECs with TNF-α. We measured the expression levels of MCP-1, ICAM-1, and VCAM-1 mRNA and of MCP-1, ICAM-1, and VCAM-1 biomarkers after treatment of HUVECs with TNF-α. Results: The DPPH and ABTS radical scavenging activity of ASCP increased in a concentration-dependent manner. NF-κB, IκB, ERK, p38 protein expression levels decreased following ASCP treatment at all concentrations compared to untreated control HUVECs. JNK protein expression levels decreased in ASCP-treated HUVECs compared to untreated controls at concentrations of 100 ㎍/mL. MCP-1 mRNA expression level decreased with ASCP treatment ≥200 ㎍/mL compared to the control. ICAM-1 and VCAM-1 mRNA expression levels decreased at all concentrations compared to the control. MCP-1 protein expression level was reduced compared to the control at concentrations ≥200 ㎍/mL, ICAM-1 protein expression level was reduced compared to the control at concentrations ≥100 ㎍/mL, and VCAM-1 protein expression level was reduced at all concentrations. Conclusions: These results suggest that ASCP has an antioxidative and hypolipidemic effect and that ASCP could treat and prevent dyslipidemia, atherosclerosis, and cardio-cerebrovascular diseases.

Factors Associated with Unawareness of Early Symptoms of Stroke and Myocardial Infarction in Adults with Hypertension and Diabetes: Focused on Management related to Disease (고혈압, 당뇨병 성인의 뇌졸중 및 심근경색증 조기 증상 비인지 관련 요인: 질병 관리 관련 특성을 중심으로)

  • Kwon, Young-Sook
    • Journal of the Korean Applied Science and Technology
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    • v.38 no.1
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    • pp.60-74
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    • 2021
  • The purpose of this research was to determine the degree of awareness of early symptoms of stroke and myocardial infarction in adults diagnosed with hypertension and diabetes, and to analyze factors related to unawareness. Raw data from the 2017 Community Health Survey were utilized. A total 12,277 adults older than 40 years were included in analysis finally. The early symptom awareness rates of stroke and myocardial infarction were 53.6% and 46.8%, respectively. Logistic analysis was performed to assess factors associated with unawareness of early symptom of stroke and myocardial infarction. After correcting for socio-demographic variables, education for the management of hypertension, recognition of blood pressure level and HbA1c level were significantly related to stroke early symptom unawareness on multivariate analysis. (Education for the management of hypertension, recognition of blood pressure level and HbA1c level were significantly related to the unawareness of early stroke symptoms even after socio-demographic variables were corrected in multivariate analysis.) Recognition of blood pressure level and HbA1c level were also significantly associated with unawareness of early symptoms of myocardial infarction. Therefore, it is required to interventions and strategies to improve the level of awareness of early symptoms of cardio-cerebrovascular disease, such as accelerating promotion and strengthening education for high-risk groups who must manage both hypertension and diabetes.

Detection of Tracheal Sounds using PVDF Film and Algorithm Establishment for Sleep Apnea Determination (PVDF 필름을 이용한 기관음 검출 및 수면무호흡 판정 알고리즘 수립)

  • Jae-Joong Im;Xiong Li;Soo-Min Chae
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.23 no.2
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    • pp.119-129
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    • 2023
  • Sleep apnea causes various secondary disease such as hypertension, stroke, myocardial infarction, depression and cognitive impairment. Early detection and continuous management of sleep apnea are urgently needed since it causes cardio-cerebrovascular diseases. In this study, wearable device for monitoring respiration during sleep using PVDF film was developed to detect vibration through trachea caused by breathing, which determines normal breathing and sleep apnea. Variables such as respiration rate and apnea were extracted based on the detected breathing sound data, and a noise reduction algorithm was established to minimize the effect even when there is a noise signal. In addition, it was confirmed that irregular breathing patterns can be analyzed by establishing a moving threshold algorithm. The results show that the accuracy of the respiratory rate from the developed device was 98.7% comparing with the polysomnogrphy result. Accuracy of detection for sleep apnea event was 92.6% and that of the sleep apnea duration was 94.0%. The results of this study will be of great help to the management of sleep disorders and confirmation of treatment by commercialization of wearable devices that can monitor sleep information easily and accurately at home during daily life and confirm the progress of treatment.

Role of Adjunctive Tranexamic Acid in Facilitating Resolution of Chronic Subdural Hematoma after Surgery

  • Kiyoon Yang;Kyung Hwan Kim;Han-Joo Lee;Eun-Oh Jeong;Hyon-Jo Kwon;Seon-Hwan Kim
    • Journal of Korean Neurosurgical Society
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    • v.66 no.4
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    • pp.446-455
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    • 2023
  • Objective : Chronic subdural hematoma (CSDH) is a common neurosurgical disease and generally treated with burr-hole surgery alone. Tranexamic acid (TXA) is an antifibrinolytic agent that potentially reduces recurrence rates and the residual hematoma volume. However, the role of postoperative TXA medication remains unclear to date. This study aimed to verify the effectiveness of adjunctive TXA in the view of early hematoma resolution. Methods : Between January 2018 and September 2021, patients with CSDH who underwent burr-hole trephination in a single tertiary institute were reviewed. The study population was divided into three groups, TXA, non-TXA, and antithrombotics (AT) groups, according to the medical history of cardio-cerebrovascular disease and TXA administration. The primary endpoint was CSDH recurrence, defined as re-appearance or re-accumulation of CSDH requiring neurosurgical interventions. The secondary outcome was CSDH resolution, defined as complete or near-complete resorption of the CSDH. The CSDH resolution time and serial changes of hematoma thickness were also investigated. Results : A total of 240 patients was included in the analysis consisting of 185 male and 55 female, with a median age of 74 years. During the median imaging follow-up period of 75 days, 222 patients were reached to the primary or secondary endpoint. TXA was administered as an adjunctive therapy in 41 patients (TXA group, 16.9%) while 114 patients were included in the non-TXA group (47.9%) and 85 were in the AT group. The recurrence rate was the lowest in the TXA group (2.4%), followed by non-TXA (7.0%) and AT (8.2%) groups. However, there was no statistical significance due to the small number of patients with recurrence. CSDH resolution was achieved in 206 patients, and the median estimated time to resolution was significantly faster in the TXA group (p<0.001). Adjunctive TXA administration was a significant positive factor for achieving CSDH resolution (p<0.001). The hematoma thickness was comparable among the three groups at the initial time and after surgery. However, CSDH thickness in the TXA group decreased abruptly in a month and showed a significant difference from that in the other groups (p<0.001). There was no TXA-related adverse event. Conclusion : The adjunctive use of TXA after CSDH surgery significantly facilitated the resorption of residual CSDH and resulted in the early CSDH resolution. Adjunctive TXA may be an effective treatment option to reduce recurrence by enhancing CSDH resolution in the selective patients.