• Title/Summary/Keyword: coronary heart disease risk

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뇌경색환자의 혈액학적 소견 연구 (The Hematologic Study on Cerebral Infarction)

  • 김윤식
    • 혜화의학회지
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    • 제12권2호
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    • pp.1-9
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    • 2004
  • 1. Purpose Stroke is the most frequent cause of mortality and morbidity rate in Korea with coronary heart disease and cancer. The ischemic type of stroke is increasing tendency. The purpose of this studies is to examine the hematologic difference between cb infarction patients and Korean normal adults. 2. Method The study group consisted of neurologically confirmd 50 cb-infarction patients as the case group and 278 patients as control group that they had no significant result by CT through early examination of stroke in Cheonan oriental hospital of Daejeon university. We tested and compared RBC, hemoglobin, hematocrit, WBC, PT, PTT, total protein, albumin, total bilirubin, direct bilirubin, GOT GPT, $\gamma$-GTP, total cholesterol, triglyceride, HDL-C, glucose, BUN, creatinine, Na, K in the both group. 3. Result In the sample group(cb infarction group), there were many patients with low RBC count but no significant and with low hemoglobin, hematocrit(p<0.05). Thereas, increased WBC count and delayed PTT were showed respectively 20%, 36% in patient group, 7.9%, 4.7% in normal group(p<0.05). Comparing the LFT between cb infarction patients and normal adults, we founded significant cases with low HDL-C level, high glucose level, low potassium level in patient group(p<0.05). But the percentage of high total cholesterol level and triglyceride level were 18%, 29%(norma1 group), 20%, 28%(cb infarction group) respectively, there were no significant difference. 4. Conclusion In this study, we demonstrated that low HDL-C level and high glucose level is one of important risk factor of cb infarction. Also prospective studies are needed to evaluate many risk factor(hemoglobin, hematocrit, WBC, cholesterol, triglyceride, K, etc) of cb infarction.

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Evidence-based estimation of health care cost savings from the use of omega-3 supplementation among the elderly in Korea

  • Hwang, Ji-Yun;Kim, Wu Seon;Jeong, Sewon;Kwon, Oran
    • Nutrition Research and Practice
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    • 제9권4호
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    • pp.400-403
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    • 2015
  • BACKGROUND/OBJECTIVES: By the year 2050, thirty-eight percent of the Korean population will be over the age of 65. Health care costs for Koreans over age 65 reached 15.4 trillion Korean won in 2011, accounting for a third of the total health care costs for the population. Chronic degenerative diseases, including coronary heart disease (CHD), drive long-term health care costs at an alarming annual rate. In the elderly population, loss of independence is one of the main reasons for this increase in health care costs. Korean heath policies place a high priority on the prevention of CHD because it is a major cause of morbidity and mortality. SUBJECTS/METHODS: This evidence-based study aims to the estimate potential health care cost savings resulting from the daily intake of omega-3 fatty acid supplementation. Potential cost savings associated with a reduced risk of CHD and the medical costs potentially avoided through risk reduction, including hospitalizations and physician services, were estimated using a Congressional Budget Office cost accounting methodology. RESULTS: The estimate of the seven-year (2005-2011) net savings in medical costs resulting from a reduction in the incidence of CHD among the elderly population through the daily use of omega-3 fatty acids was approximately 210 billion Korean won. Approximately 92,997 hospitalizations due to CHD could be avoided over the seven years. CONCLUSIONS: Our findings suggest that omega-3 supplementation in older individuals may yield substantial cost-savings by reducing the risk of CHD. It should be noted that additional health and cost benefits need to be revisited and re-evaluated as more is known about possible data sources or as new data become available.

식품 중 식이섬유(Dietary fiber)의 의미와 기능성 고찰 -식이섬유의 특성과 기능을 중심으로- (Gerneral concept of dietary fiber and it's functionality)

  • 신동화
    • 식품과학과 산업
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    • 제52권1호
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    • pp.84-99
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    • 2019
  • Dietary fiber is defined as soluble and insoluble polysaccharide consisted in the plant cell wall-associated fibers naturally occurring in fruits, vegetables, and cereal products, and of isolated fibers that are added to processed foods which are also artificially modified. There are so many difference types of dietary fibers as arabinoxylan, polydextrose chicory, oligosccharide. inulin, pectin, bran, cellulose, ${\beta}$-glucan, resistant starch and some seaweed polymers as alginate. Most of them provide many biological benefits in the intestine, as lower risk for developing coronary heart disease, stroke, hypertension, diabetes, obesity and some of the gastrointestinal disease like as colon cancer. And also lowering cholesterol levels, improves glycemic and insulin sensitivity to non-diabetic and diabetic persons including immune system. Beside of many benefits, average consumers in developed and under developing countries take far less amounts of dietary fiber that international organization recommended. Adequate intake of dietary fiber is 14g/1,000kcal base using the energy guide line of 2,000kcal/day for women and 26,000 kcal/day for men, dietary intake is 28g/day of adult women and 36g/day for adult men. The mechanisms behind the reported effects of dietary fiber on metabolic health are not fully well established. It is suggested that changes in intestinal viscosity resulting mucus increasing, macro-nutrients absorption, rate of passage of large intestinal, production of short chain fatty acids by fermentation. Production of gut hormones and changes of microbiota in intestine. It is necessary to do more research in this field in the future and combined interdisciplinary works together.

고혈압과 apolipoprotein E의 다형성 (The Effect of Apolipoprotein E Polymorphism on Hypertension in Korean Adults)

  • 최대경;김금하;박상현;임정수
    • 농촌의학ㆍ지역보건
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    • 제32권2호
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    • pp.87-96
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    • 2007
  • Background: Apolipoprotein E has been one of the most thoroughly studied genetic polymorphisms, particularly for its effects on lipid profiles and coronary heart disease risk. This study investigated the relationship between the apolipoprotein E polymorphism and essential hypertension in a Korean population. Methods: The subjects (n=1,243) were participants in a population-based study in Incheon metropolitan City, Korea. The apolipoprotein E polymorphism was determined using a polymerase chain reaction method. Results: The frequencies of the genotypes did not differ significantly between the hypertensive groups (60.0% ε2 / ε2, 30.8% ε2 / ε3, 44.4% ε2 / ε4, 33.3% ε3 / ε3, 32.3% ε3 / ε4, and 15.4% ε4 / ε4; p=0.498). After adjusting for other risk factors, genotypes were not associated with hypertension(OR 5.74, 95% CI 0.81-40.76, ε2 / ε2 vs. ε3 / ε3; OR 0.94, 95% CI 0.60-1.47, ε2 / ε3 vs. ε3 / ε3; OR 1.21, 95% CI 0.30-4.89, ε2 / ε4 vs. ε3 / ε3; OR 0.79, 95% CI 0.56-1.13, ε3 / ε4 vs. ε3 / ε3; OR 0.29, 95% CI 0.06-1.45, ε4 / ε4 vs. ε3 / ε3). Conclusions: These findings suggest that the apolipoprotein E polymorphism is not associated with hypertension.

Iron Status of Femele Athletes Involved in Aerobic Sports

  • Kim, Hye Young P.;Jang, Young-Ai;Jang, Young-Ai
    • Nutritional Sciences
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    • 제1권1호
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    • pp.29-33
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    • 1998
  • The present study was designed to compare the nutrient intake and iron status of athletic female students majoring in aerobics (n=18) to those of age-matched(20-22 yr) sedentary controls (n=19). The athletic students were exercising regularly for 9.1$\pm$1.4 hrs/wk and the mean training period of aerobics was 2.9$\pm$0.2 years. Means of height, weight, and body mass index calculated as the Quetlet index were similar between athletic and sedentary students. However, mean body fat % of the athletic students (22.3$\pm$1.0%) was significantly lower than that of the sedentary controls (25.8$\pm$0.6%), indicating the effects of routine exercise. Mean daily iron intake was not significantly different between groups (9.9$\pm$0.7 mg vs. 10.9$\pm$0.8 mg), but much lower than the Korean RDA (18 mg/d) in both groups. Dietary calcium intake of the athletic students was significantly lower than that of the sedentary controls. Hematocrit (Hct) and hemoglobin (Hb) values were significantly lower in the athletic students than in the sedentary students (Hct : 40.0$\pm$0.7% vs. 43.8$\pm$0.5% ; Hb : 12.6$\pm$0.3g/dl vs. 14.8$\pm$0.3 g/dl). However, other iron status values such as serum iron, TIBC, and transferrin saturation were not significantly different between groups. Therefore, the low hemoglobin levels in the athletic group are probably due to plasma dilution in endurance-trained individuals. Serum ferritin level was a little lower in the athletic group, but no significant difference between groups was found. Serum triglyceride concentration in the athletic students was significantly lower than that in the control students. In conclusion the findings suggest that regular training of female athletes majoring in aerobics is associated with an increased risk of pseudoanemia due to plasma volume expansion and a decreased risk of coronary heart disease by decreasing body fat and blood lipid level.

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Cholesteryl Ester Transfer Protein (CETP) Deficiency and CETP Inhibitors

  • Mabuchi, Hiroshi;Nohara, Atsushi;Inazu, Akihiro
    • Molecules and Cells
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    • 제37권11호
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    • pp.777-784
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    • 2014
  • Epidemiologic studies have shown that low-density lipoprotein cholesterol (LDL-C) is a strong risk factor, whilst high-density lipoprotein cholesterol (HDL-C) reduces the risk of coronary heart disease (CHD). Therefore, strategies to manage dyslipidemia in an effort to prevent or treat CHD have primarily attempted at decreasing LDL-C and raising HDL-C levels. Cholesteryl ester transfer protein (CETP) mediates the exchange of cholesteryl ester for triglycerides between HDL and VLDL and LDL. We have published the first report indicating that a group of Japanese patients who were lacking CETP had extremely high HDL-C levels, low LDL-C levels and a low incidence of CHD. Animal studies, as well as clinical and epidemiologic evidences, have suggested that inhibition of CETP provides an effective strategy to raise HDL-C and reduce LDL-C levels. Four CETP inhibitors have substantially increased HDL-C levels in dyslipidemic patients. This review will discuss the current status and future prospects of CETP inhibitors in the treatment of CHD. At present anacetrapib by Merck and evacetrapib by Eli Lilly are under development. By 100mg of anacetrapib HDL-C increased by 138%, and LDL-C decreased by 40%. Evacetrapib 500 mg also showed dramatic 132% increase of HDL-C, while LDL-C decreased by 40%. If larger, long-term, randomized, clinical end point trials could corroborate other findings in reducing atherosclerosis, CETP inhibitors could have a significant impact in the management of dyslipidemic CHD patients. Inhibition of CETP synthesis by antisense oligonucleotide or small molecules will produce more similar conditions to human CETP deficiency and may be effective in reducing atherosclerosis and cardiovascular events. We are expecting the final data of prospective clinical trials by CETP inhibitors in 2015.

Synthesis of Reconstituted High Density Lipoprotein (rHDL) Containing apoA-I and apoC-III: the Functional Role of apoC-III in rHDL

  • Cho, Kyung-Hyun
    • Molecules and Cells
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    • 제27권3호
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    • pp.291-297
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    • 2009
  • Apolipoprotein (apo) C-III is a marker protein of triacylglycerol (TG)-rich lipoproteins and high-density lipoproteins (HDL), and has been proposed as a risk factor of coronary heart disease. To compare the physiologic role of reconstituted HDL (rHDL) with or without apoC-III, we synthesized rHDL with molar ratios of apoA-I:apoC-III of 1:0, 1:0.5, 1:1, and 1:2. Increasing the apoC-III content in rHDL produced smaller rHDL particles with a lower number of apoA-I molecules. Furthermore, increasing the molar ratio of apoC-III in rHDL enhanced the surfactant-like properties and the ability to lyse dimyristoyl phosphatidylcholine. Furthermore, rHDL containing apoC-III was found to be more resistant to particle rearrangement in the presence of low-density lipoprotein (LDL) than rHDL that contained apoA-I alone. In addition, the lecithin:cholesterol acyltransferase (LCAT) activation ability was reduced as the apoC-III content of the rHDL increased; however, the CE transfer ability was not decreased by the increase of apoC-III. Finally, rHDL containing apoC-III aggravated the production of MDA in cell culture media, which led to increased cellular uptake of LDL. Thus, the addition of apoC-III to rHDL induced changes in the structural and functional properties of the rHDL, especially in particle size and rearrangement and LCAT activation. These alterations may lead to beneficial functions of HDL, which is involved in anti-atherogenic properties in the circulation.

고혈압 복합제 복용환자에서 동일계열약물 중복 현황 (Class duplication prescriptions in patients taking fixed-dose combination antihypertensives)

  • 구현지;이지원;최하은;제남경;정경혜
    • 한국임상약학회지
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    • 제32권2호
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    • pp.125-132
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    • 2022
  • Background: Fixed-dose combinations have the advantage of improving patient compliance, but may increase the risk of duplicate prescriptions. As the use of fixed-dose combination antihypertensives increases, it is necessary to investigate the current status of class duplication prescriptions (CDP) in patients taking fixed-dose combination antihypertensives in Korea and to identify factors associated with CDP. Methods: We conducted a retrospective observational study using nationally representative claim data. Hypertensive patients aged 20 years or older taking fixed-dose combination antihypertensives were extracted. Among these patients, patients with CDP were identified. A chi-square test was applied to determine the differences between patients with CDP and non-CDP. The associated factors of CDP were identified through multiple logistic regression. Results: Of the 74,165 patients who were prescribed fixed-dose combination antihypertensives, 426 patients (0.6%) with CDP were identified. The most common antihypertensive class associated with CDP was calcium channel blockers (194 patients, 45.5%), followed by angiotensin II receptor blockers (136 patients, 31.9%). Patients aged 75 years or older (odds ratio [OR] 1.83, 95% confidence interval [CI] 1.02-3.52), chronic kidney disease (OR 4.45, 95% CI 2.15-8.25), chronic heart failure (OR 2.71, 95% CI 1.93-3.72), coronary artery disease (OR 2.22, 95% CI 1.60-3.03) and Medical Aid/Patriots and Veterans Insurance (OR 1.49, 95% CI 1.04-2.07) were significantly associated with increased CDP. Conclusions: The factors associated with CDP were the elderly, comorbidities, and low socioeconomic status. Since CDP can result in negative clinical outcomes, active intervention by the pharmacist is warranted.

수면과 관련된 호흡장애가 심혈관계의 기능 변화에 미치는 영향 (Influence of Sleep-Related Breathing Disorders on Changes of Cardiovascular Function)

  • 문화식
    • 수면정신생리
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    • 제4권2호
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    • pp.129-139
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    • 1997
  • 수면 무호흡을 포함한 다양한 원인의 수면과 관련된 호흡장애를 동반한 환자들에서는 여러가지 심혈관계 기능부전이 초래되어 이들 환자의 임상경과에 중대한 영향을 미친다. 수면 무호흡증후군, 특히 폐쇄성 수면 무호흡증후군은 수면장애의 여러 가지 원인 중 임상영역에서 가장 흔히 볼수 있는 질환으로 전신성 고혈압, 심부정맥, 폐동맥 고혈압 및 우심실 부전, 협심증 및 심근경색증, 뇌졸증등의 발병률이 정상인에 비하여 현저히 높은 것으로 알려져 있다. 폐쇄성 수면 무호흡과 달리 중추성 수면 무호흡은 수면중에 호흡중추를 불안정하게 하는 다양한 원인에 의해 발생하며 역시 심혈관계의 기능에 영향을 미칠 수 있다. 수면중에 환기장애가 더욱 악화될 수 있는 호흡기계 질환이 있는 환자들은 수면 무호흡증후군과 달리 만성적인 저산소증과 고탄산증이 동반되며 이로 인해 심부정맥, 폐동맥 고혈압, 우심실 부전(폐성심) 등의 심혈관계 이상이 초래될 수 있다. 따라서 수면 무호흡을 포함한 수면과 관련된 호홉 장애의 진단과 치료에 있어서는 호흡기계 질환에 대한 정확한 평가와 더불어 동반될 수 있는 심혈관계의 기능부전에 대한 정밀한 분석이 반드시 필요하며, 이들 자료를 바탕으로 기관절개술, 기계적 호흡, 지속적 양압공급치료, 적절한 산소요법 등의 적극적이고도 효과적인 치료법을 적용함으로서 심혈관계 합병증의 발생과 이로 인한 사망률을 감소시킬 수 있을 것으로 생각된다.

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75세 이상 고령환자의 관상동맥우회로술 (Coronary Artery Bypass Grafting in Elderly Patients Older Than 75 Years)

  • 유동곤;김종욱;박종빈;주석중;이재원;송명근;송현
    • Journal of Chest Surgery
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    • 제38권2호
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    • pp.123-131
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    • 2005
  • 배경: 관상동맥우회로술을 받는 고령환자가 증가하는 추세이다. 고령환자는 비교적 높은 수술합병증과 사망률을 보인다. 관상동맥우회로술을 받은 고령환자의 수술사망과 합병증에 영향을 주는 위험인자를 알아보았다. 대상 및 방법: 1995년 1월부터 2003년 7월까지 서울 아산병원에서 관상동맥우회로술을 시행 받은 75세 이상의 고령환자 91명을 연구대상으로 하였다. 남자가 67명이었고 여자는 24명이었다. 평균나이는 $77{\pm}2.4$세로 75세에서 88세까지 분포했다. 30종류의 임상적, 혈 역학적 변수를 수술사망 및 합병증에 영향을 추는 위험인자로 가정하고 이들의 연관성을 분석하였다. 걸과: 5명의 환자에서 응급수술을 시행하였다. 85명의 환자에서 내흉동맥을 사용하였고 10명의 환자에서는 양측 내흉동맥을 사용하였다. 원위부문합 수는 평균 3.7개였다. 수술사망률은 $3.3\%$ (3/91)였다. 22명의 환자에서 최소한 한 가지 이상의 합병증이 발생하였다. 저심박출증후군이 9예$(9.9\%)$로 가장 많았으며 출혈로 인한 재수술 6예$(6.6\%)$, 폐부전 5예$(5.5\%)$, 심근경색증 4예$(4.4\%)$, 뇌졸중 3예$(3.3\%)$, 급성신부전 3예$(3.3\%)$, 심실성 부정맥 2예$(2.2\%)$, 상부위장관 출혈 2예$(2.2\%)$, 감염 2예$(2.2\%)$, 그리고 지연흉골봉합이 1예$(1.1\%)$였다. 통계상으로 수술사망과 연관이 있는 위험인자는 없었고 신부전, 말초혈관질환, 응급수술, 최근의 심근경색증, 울혈성심부전, New York Heart Association (NYHA) class III 또는 IV, Canadian Cardiovascular Society (CCS) 협심증 III 또는 IV, 그리고 $40\%$ 이하의 저심박출계수가 전체적인 합병증에 영향을 주는 위험인자로 분석되었다. 1년, 3년, 5년 생존율은 각각 $94.9\%,\;89.8\%,\;83.5\%$였다. 추적관찰 중 $93.3\%$의 환자가 NYHA class I 또는 II였고 $91.1\%$의 환자는 협심증 증상이 없었다. 결론: 75세 이상 고령환자에서 관상동맥우회로술은, 합병층 발생이 다소 높기는 하지만 만족스러운 수술사망률과 우수한 장기결과를 보여주어 선택적 환자에서 적극적으로 시행할 수 있다.